September 29, 2022 • 52 mins
In 1973 a study was published in Science where psychologist David Rosenhan revealed he had duped hundreds of psychiatric workers by planting perfectly sane pseudopatients within their hospitals and every last one went unnoticed.
See omnystudio.com/listener for privacy information.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
Welcome to Stuff you Should Know, a production of I
Heart Radio. Hey, I'm welcome to the podcast. I'm Josh,
and there's Chuck and Jerry's here, capetch ng. And that
makes this a normal episode of Stuff you should Know.
That's right, the continuing bucket of Josh's obsession with psychology
(00:25):
and psychiatry. It's so interesting. I know, I love it.
These always come from you, and they're always interesting, So
let's do it. So we're talking today specifically about a
particular study, a very famous psychology study. UM. And the
whole thing is kind of rooted in context that you
have to know, which is that UM. There was a
(00:47):
time up until about the fifties when psychiatrists were considered
like unquestionable, no matter how weird or brutal or potentially
lie taking their methods were. If it was if it
was a psychiatrist saying this is needed for mental health,
then society just went along with it, right. But then
(01:11):
at some point in time there was kind of this
backlash against that because people started questioning, like, are you
sure you guys know what you're talking about? And if
you don't, UM, what you're doing is even more horrific
than we thought before. And I was trying to think
of a good analogy, Chuck, and the best I could
come up with is, let's say you gave a group
of church officials free, free reign to hunt witches, tortures
(01:37):
suspected witches, violently exercised demons from from um people who
are possessed, and then society figured out that not that
those things don't exist, but that in this case, the
church officials themselves don't exist. Right, So, in this case,
(01:59):
mental illness does exist, but the witch hunters don't aren't
actually real, their methods don't mean anything. They're completely made up.
And that was the crisis of confidence that psychiatry was
going through in the middle of the twentieth century. People
started doubting that it had any kind of veracity whatsoever,
and that they were just torturing mentally ill people to
(02:19):
try to figure it out as they went along. Yeah,
and I'm not going to get on some anti medication,
anti psychiatry soapbox, but I will say this, and you
know this about what's been going on in my private life.
But I have seen a very sad situation of someone
I love dearly in my own life over the past
few years deteriorate. Because while conditions in like let's just
(02:44):
call them asylums what they call them back then, have
certainly improved, Uh, there's still a lot of lines that
can be drawn to doctors forgetting when it comes to
mental illness, forgetting there as a human sitting there in
front of them, uh, when medication is being thrown at them.
(03:05):
And again the medication can be great, not going on
some big tirade against uh uh antipsychotic meds and things
like that. But I've just seen it happen up close
and impersonal, and it is a it is still a
very broken system in many ways, and it's really really sad. Yeah,
And what you just mentioned is it's a longstanding kind
(03:25):
of tack that psychiatry has taken, which is they're battling
the disease and the patient is just kind of an
unfortunate casualty of that battle sometimes, you know what I mean.
And so finally people stood up and said like wait, wait, wait, wait, wait,
we need to like rethink this psychiatry. Like you guys
are giving people lobotomies, You're throwing powerful um like psychotropic
(03:48):
medications at people that can rob them of their will.
Um and rob them of their personalities, like we need
to rethink this, And something called the anti psychiatry movement
started to develop, um, both in the general public and
amongst some psychiatrists and psychologists themselves, and in the Church
of scientology. Yes, scientologists hate this stuff, um, but they
(04:10):
really are kind of vehemently opposed to the entire idea,
it seems like, whereas this was more like the anti
psychiatry movement, especially within the profession, was like, Okay, our
goals are noble. What we're trying to do is worthwhile.
We just don't know what we're talking about yet, and
we need to figure out a better strategy. Yeah, And
(04:30):
as we'll see, certain things like if you listen to
our episode on Titticut Follies, things like that popped up
here and there throughout history to make people really pump
the brakes and go, wait a minute, how how are
we treating people with mental illness in this country? Like?
What the heck is going on? So there was a
a person named R. D. Lange who was um didn't
(04:54):
like to be like fully put in the box of
like anti psychiatry, but was certainly criticized and questioning the
fact that Hey, Um, we're observing these behaviors. It's a
behavioral things that we're witnessing, and we're treating them biologically,
and like, there's there's something missing here. There's a piece
that's missing. And R. D. Lange was giving a lecture
(05:18):
one time that was seen by a gentleman that we're
talking about today, David Rosenhand, who was a psychologist and
rosen Han. I guess it. You know it touched a
nerve with rosen Han or is it Rosenhand? You know
I've always said hand, Okay, Rosenhand, that's what we'll go with.
We definitely won't switch back and forth Overard. No, well,
(05:39):
we definitely won't say I'm both in secession. But Rosenhand said, Hey,
this lecture spoke to me. Um, tagging someone is mentally
ill quote unquote mentally ill is does humans a disservice
because that's a tag that they live with, not only
in the eyes of others, but to themselves, and it
(05:59):
can calls real damage. Um, and some of these people
aren't mentally ill. So we need to really take a
look at this. And I have some ideas on how
to tackle it. Yeah, and we should say in this episode,
we're going to use the word sane and insane a lot,
and nowadays you would call that healthy or mentally ill
um And the reason we're kind of using it like
(06:21):
that's number one, that's the terms they used back then.
But also it's different. It was a different understanding that
back then that there there wasn't gradiations of mental wellness.
There was you were sane or else you were insane.
And once you were insane or labeled insane, you had
that label for life. You were in remission, but you
still had that that label of you know, that you
(06:43):
carried around for the rest of your life. Yeah, that's
a good point. I'm glad you made that. Actually. Uh so.
Rosen Han also at some point previous to this, underwent
a experimental eight day in patient uh you know, and
this was rosen and wasn't like a Rosenhand there I go.
(07:03):
Wasn't saying, oh, I'm not feeling well, I'm gonna try this.
Rosenhand said all right, I'm completely saying I'm gonna check
myself in for eight days as an impatient and see
what happened. Because I want to maybe convince some of
my students to do this. After he did it, he
was like, well, that was intense. I definitely am not
going to ask my students to do this. What I'm
gonna do is design and experiment where we can have
(07:26):
non students do this and then I can tell them
what happened. Right, And the basis of it was just
one kind of very central question, right, right. So Um
Rosine haine Um decided that he was going to design
an experiment using those two experiences, and he wanted to
see if psychiatrists could do the most basic part of
(07:49):
their job, which is identify the difference between a sane
person and an insane person. Yeah, and this, it really
did make me wonder if he was influenced at all
by One Flew Over the Cuckoo's Nest. I don't know.
I saw that he started this in nineteen sixty nine.
When was that book published sixty two or sixty three.
(08:11):
It's entirely possible and was the stage play, and the
whole basis of One Flew with the Cuckoo's Nest was, Uh,
if you haven't seen the movie or read the book,
which is the both great Uh, it was it was
a gentleman who was always in trouble with the law
who basically saw a way around going to prison, and
that was, um, let me try and convince them I'm
insane and we'll be put in a cushy mental institution instead.
(08:35):
So the whole basis of that, it's a little different.
But was put a sane person in an insane asylum?
Again words they use back then, Uh, and let's see
if I can fool them. Yeah. And that was written
by Ken Kesey, who figures big time into the electric
kool aid ASCID test. And he was actually on the
ward of a state psychiatric facility in either Oregon or
(08:59):
Washington and and he like witnessed this stuff and ended
up writing a book. And he was as we'll see,
along with rosen Han man, Chuck, why did you do
that to me? Along with rosen Hand and a bunch
of other people along the years, he helped contribute to
opening society's eyes to the ills of institutionalizing the mentally
(09:21):
ill and how they were treated. Yeah. Absolutely. Um, So
rosen Han gets in there, I'm gonna say on looks
like Conomy go ahead and says, all right, here's what
I'll do. And this is all in the in the
sort of pre study like planning part. I'm gonna call
these people's pseudo patients. I'm gonna gather together people who
are what I would call perfectly saying, they've never had
(09:42):
any history of mental illness. They would go to a
psychiatric hospital and they would say, hey, I'm hearing voices. Uh.
If it was a man, they would say, I'm hearing
a man's voice. It was a woman, they would hear
a woman's voice, and it's sort of unclear what they're saying,
but I'm hearing the words uh, empty or thud or
hollow um, And I figured I should talk to someone
(10:05):
about it and let's see what happens. Yeah. And so
later people who came and have studied and analyzed this
um believed that rosenhan Was was trying to simulate existential symptoms,
possibly in existential psychosis, that where somebody has some serious
concerns about the meaning of existence all of a sudden
(10:25):
they're really concerned that they don't mean anything, that there's
no purpose to life, and that he was trying to
kind of come up with that using those words. The
thing is, after they presented themselves at the psychiatric facility
and they gave this false initial complaint. They were also
required to give a false name. They were also required
to give a false occupation because a lot of these
(10:46):
pseudo patients were actually psychologists and psychiatrists themselves, and that
would have raised red flags for sure. But also he
was worried that they would have gotten special treatment. It
would have altered the outcome of the data were collecting.
But other than that, other than those three things, the
deception ended there. They were supposed to behave exactly like
(11:07):
they normally would uh as themselves from from that point on. Yeah,
So like when they did interviews and stuff, whether it
was intake or just as they went, although we'll see
that didn't happen a lot. As they went. Uh, they
were to describe their lives as they were, uh, their
personalities as they were, their relationships, their medical history. Everything
(11:29):
was just straight up and on the straight and narrow. Um.
This is very key. They did not take the medications. Uh.
They would, you know, do the old trick where you
hide them, uh misery style and then uh and then
put them like under your mattress or something, or I
guess plush them down the toilet. Um. And they were uh.
(11:49):
And of course rosen hand is saying that, uh, it's
very natural how it happens. It's funny. Rosen And was saying, like, hey, anything,
this thing is biased in the favor of these institutions,
because like this is the very barest thing that they
should be able to tell if someone is sane or insane,
(12:12):
and these are completely sane people, so they should really
be recognized as frauds. Like this shouldn't be too hard
for them. Yeah, I mean, like, if you're presented with
somebody who has a perfectly normal, perfectly healthy life background history, um,
like yeah, you should be able to recognize him as saint.
So that was the premise of the whole thing. He
also said that they while they were in there, if
(12:33):
they were accepted into the facility, they were to become
quote paragons of cooperation. That if they were given an
instruction from somebody on the staff, they were supposed to
happily comply and follow it. Um, they were supposed to
just kind of go along and get along, not cause
any waves or any trouble. And that he noticed that
there's like a built in mechanism to kind of support
(12:54):
people from to to be uh cooperative, and that is
that they presented themselves as psychiatric patients without anyone in
these hospitals being informed that they were there, So they
had no idea when they were going to get out.
They needed to be on their best behavior and seem
as seen as possible so that they could eventually get out. Yeah,
(13:17):
and this is where it really differs from Cuckoo's Nest
because the main character there, McMurtry, was not cooperative at all,
and that you know that led to the tragic ending.
But man, yeah, what a movie. What a book. I've
never read the book is that as as good as
the movie is. It one of those rare things where
(13:37):
the movies even better than they're both great. It's it's
like a great book, great movie. Yeah, really good stuff. Um. So,
the other thing he had in his or claim to
have in his hip pocket you can put a pin in.
This is a writ of habeas corpus for each patient
in case. Uh. They just were like I gotta get
out of here, and the hospitals like, sorry, it doesn't
(13:59):
work that way. Habeas rid of habeas corpus has to
do with reporting unlawful detentions, and so rosen And said,
I've got these on hand in case anybody has to
get out. Um. And I think he presented it to
the pseudo patients that way too, right. Yeah, so don't
worry like if it if it really, if push comes
to shove, I can get you out of there through
(14:20):
the courts basically. So um. And it is really important
to know when you're voluntarily checking yourself into a mental
facility for the purposes of a deceptive study, right, um.
And one of the things that Rosenhand needed for this
study was for pseudo patients to take copious notes and
observe everything um shot down, interactions, shot down, how they
(14:42):
were treated, how other patients were treated, um, just basically
everything they could document they were supposed to document, and
Rosenhand was initially really worried that this is going to
kind of show the pseudo patients hands. So they needed
to take these notes secretly, and the pseudo patients figured
out very quickly. No one at the psychiatric facility who
(15:03):
worked there could have cared less that they were taking
notes the entire time, and in fact, they actually, in
at least one case, attributed it to their um their
psychological condition. Yeah, I mean this, um, I think it
speaks to some of the results that we'll find, which
was there a lot of time, was not a lot
(15:23):
of active participation from staff to patient. So they're like,
I don't care, he's writing big whoop, right there was
There was a note in one of their files patient
engages in writing behavior, but that was it. They didn't
think it was weird. They didn't think that whatever happened,
those patients just took notes on everything. They were insane
and so of course an insane person is going to
(15:45):
do that. And so the pseudo patients were able to
just take notes out in the open the entire time
during their stays. I think when you write engages in
and tech behavior on the end, you can make anything
like Josh and Chuck exhibited pie casting behavior right exactly
when all of a sudden, someone's coming after us. All right,
(16:06):
so the study is now designed. Um, he starts, Uh,
he's collected these pseudo patients, these volunteers, I guess, and uh,
he wants to collect data in the end. Um, we
should note that he did throw out the data from
one participant because they, I think, kept making stuff up
(16:27):
while they were in there and didn't didn't go with
the reality of their life. Um. And then another and
I have no idea why this person's data wasn't excluded.
But another person tried, and this is very McMurtry esque.
Although he hated Nurse Ratchet, but he tried to uh
to woo a nurse on the premises. Uh said that
(16:49):
he was a psychologist, and UH actually provided psychotherapy to
some other patients there. Yeah. I suspect that they didn't
throw that data out because it was Rosenhan himself. Oh,
that would be my guest. My data is still good.
I didn't think of that because he was one of
(17:11):
the eight pseudo patients at all who went to twelve
different places in this study. Very interesting. I think it's
a great place for a break. Ye. All right, I'm
gonna ponder that whole scene. Uh, and we'll be right back. Alright.
(17:44):
So it's nineteen it's funny. It was published in Science
in nineteen seventy three. But I didn't see I couldn't
find anywhere when this happened. When did it actually happen?
I saw seventy two. It's weird. I looked in a
bunch of places and it all just dived right into
the thing without saying what ear it was? Yeah, I
said I noticed that too. I found it in one place.
All right, So seventy two The Summers of Love and
(18:09):
eventually published in Science, which, of course we've talked about
it a lot. It's one of, um, if not the
most prestigious academic journal in US history. So it's not
like it was published in Popular Mechanics or something like that. Hey,
Popular Mechanics is pretty great, or BuzzFeed. Sorry, let's say
Highlights Children. Oh, I love Highlights, which is the one
(18:29):
I was on the cover of, like like Catholic Boy's
Life or something Catholic nuns like Expelled. It was spelled
n O N E apostrophees. Uh so where were we?
All right? It's nineteen seventy three. It's published in the
(18:50):
journal Science. Uh. It was called on Being Sane and
Insane Places. And it's a really great read. You sent
me in the original article. It's awesome. You can still
find it and read it. It's a really good read
because it doesn't take the form of a regular scientific
academic journal. UM doesn't have a lot of data, not
a lot of statistics, UM, not a lot of a
(19:13):
lot of things UM methodology, like results. It's just sort
of written out like this kind of uh challenge essay, which,
as we'll see, ended up. You know, therere being a
lot of problems with it, but it makes for a
much better read than most things in science. Yeah. He
starts a lot of paragraphs with oh here's another thing,
(19:34):
right Yeah. So, Um, like I said, Rosenhan was one
of the eight pseudo patients. There were eight and all, um,
five of them were men, the other three were women. Um,
and five of the eight were somehow engaged in psychology
or psychiatry plus him, are including him? Do you know?
I think I think including him? Yeah, I think he's
(19:55):
included all of those. And um. He sent them to
twelve different facilities in five different states on the East
coast and West coast. Um, and they were all different kinds.
He specifically tried to make his sample representative of the
kind of facilities that you would find throughout the United States. Yeah. Um,
one of them was a private hospital eleven where state run. Um,
(20:17):
so not the biggest division there, but they did run
the gamut from older kind of rundown places to newer places. Uh.
Some places had um really good ratios of patient staff,
some my really crutty ones uh and not nearly enough
staff uh, somewhere research based and oriented, somewhere not at all.
(20:38):
So it seems at least that he had a pretty
decent representation, right he so Um again, in the design
of his study, he has set it up to make
it as easy as possible for anyone in these psychiatric
facilities staffs to notice that, you know, this person is
actually not mentally ill at all. They're giving us all
(21:00):
this information that's contrary to that. So he he, like
he said before, Um, he biased it in favor of
the psychiatric staff finding out that these people were saying.
And he said that there were some things that he
considered and then dismissed about why they may have been admitted,
because we haven't said it yet, but all eight were
admitted in all twelve instances, Um. And one of the
(21:22):
reasons he considers they were possibly that possibly affected the
diagnosis and their mission admission was that they were nervous,
like the site of the pseudo patients were nervous about
being found out they were They were nervous they were
going to be embarrassed or shamed or maybe get into
some sort of trouble Um. And so he said that
might have contributed a little bit, but probably no, not
enough to be admitted into a psychiatric facility. So he
(21:45):
he kind of dismisses that thought. But what he says
is that they were all really surprised at how easily
they were admitted. Yeah. I mean, I think in the
late nineties sixties, when you show up say you're hearing
voices in your head, they believe you and they say,
all right, you're, uh schizophrenic, and welcome to the facility. Uh,
here's your here's your outfit, and here's your room, and uh,
(22:08):
here's your pills. And that's basically what happened. I think
they were all save one, diagnosed with schizophrenia UM. The
one was at the private run Interestingly institution, and they
were diagnosed as what would now be bipolar disorder. Back
then they called it manic depressive psychosis. But they were
(22:29):
all ushered in basically with open arms. Yeah. And I
saw and I think a big Think article on this
UM study. They pointed out that, like this is the
opposite of what it's like when you try to get
mental health treatment today. It's really hard, it's really expensive.
You don't just show up and they let you in
and here's your gown and here's your pills kind of thing.
(22:50):
So it's kind of interesting in that respect as well.
But then once these pseudo patients were in the ward again,
they have diagnoses of schizophrenia. Now, um, there wasn't a
single instance where any of their behavior was questioned by
the staff, are considered suspicious, and um he got he
obtained most of the reports from these visits and in
(23:12):
the files, there's no questioning or suspicion whatsoever about the
pseudo patients at all. No, I mean they would uh
the reports were really good, and that all the people
were like model patients and cooperating and friendly and engaging
and like. These things were noted, but no one ever
said like, uh, and we'll see you know some of them, Well,
we'll get to that point. Because I think that's one
(23:33):
of the more remarkable parts of it is how they
noted that. But what they didn't note was like, you
know what, this person doesn't seem like there's anything going
on with them at all. Uh. It was just sort
of accepted, like they're here, so this is what is
going on with them. It's really interesting. But that was
the staff, right, What about the other patients of the facility. Yeah,
(23:55):
this I think is super fascinating. They were the only
ones that were into it. The other patients they were
basically were like, you're not one of us, and I
and we can tell um and I trying to remember
in Cuckoo's Nest, I think he basically told everyone right away,
like the other patients like I don't belong here, um,
(24:16):
and he kind of became the de facto leader. But
at uh these places with rosen Han, they've they basically said, hey,
we don't think you're real. We think you're either a
journalist um, trying to expose the facility, or maybe you're
you work for the facility and you're you know, in
there as a mole kind of checking on things. Yeah exactly,
(24:38):
but either way, we don't believe you. And it seems
like in most cases they were uh. And I love
that you actually put sniffed off the case and because
you put this together, But they were sniffed off the
case generally by just being reassured by the pseudo patients
that no, I'm just feeling better, That's why I'm acting
this way, right. Can't you just see Mr Martini saying, like,
(25:00):
I know you're checking up on the hospital. So there's
the thing that Rosenhand points out, and he just kind
of brushes past it, but it's kind of important. He
says that while the other patients you know, found them
out immediately, um, none of the pseudo patients were closely
examined by the psychiatric staff, by the actual psychiatrists. They
(25:22):
had plenty of interaction with the nurses, the order lads,
you know, the people who interact with the patient's day today.
But none of them, in all twelve instances, all twelve visits,
none of them were closely examined by a psychiatrist. And
you can imagine that an inmate or a patient at
one of these facilities is going to have the opportunity
(25:42):
to really closely pay attention to you and interact with
you and see your behavior. So it might have been
easier for them just because they interacted with them more.
But he defends this, you know, potential flaw in his
design and saying like, these hospitals had plenty of opportunity
to closely examine pseudo patients and they didn't. So whether
that was the reason they didn't find them out or not,
(26:05):
it was still a huge failing of the psychiatric system
and their process, and that they didn't even closely examine
these people to see that, oh no, actually these people
are faking. Yeah. And not to harp on Cuckoo's Nest,
but it was written, you know, as a as a
real thing that Kesy did, and it was that's what
happened in that book. He you had this initial meeting
(26:26):
with a psychiatrist where they diagnosed him, and then it's like,
all right, this is where you live now, and these
are the orderlies and these are the nurses, and this
is your life. There was no regular check ins to
see if anybody was getting better, and that was the
whole point of this experiment, and in a lot of
ways was like it wasn't being done right. These people
(26:46):
were just being sent to live away because they were
a hassle for their family. They were being sent to
live somewhere else now, right. So one of the other
themes of Um one flew over the Cuckoo's Nest is that,
you know, Jack Nicholson is kind of slowly driven crazy,
I guess you could say, from being institutionalized. It was
one of the main themes um and Rosenhan Actually I
(27:08):
don't maybe he did read that book because he accounted
for this. Um. He didn't report it I think in
the study, but um in a memoir that was found
after he died. Uh. He apparently had people visit, you know,
friends visit the patients during their stay, and then would
interview the friends to see if they noticed any actual
change in the pseudo patients, and that none of them did.
(27:30):
There was no major, you know, noticeable effect of institutionalization
that could have accounted for people you know, mistaking them
as as um, you know, having schizophrenia or something. Yeah.
And this was over the course. What was the average stay?
How many weeks? I think nineteen days, almost three weeks
for the average. Yeah. So it's it's long enough to
(27:52):
where someone could have said to a visitor like, hey,
this place is really wearing on me, starting to lose
it a little bit. Uh, And apparently that didn't happen. Um.
This is the part that I think really fascinated me
was that, Uh, the more saying they were, which was
to say, uh, saying appearing um, the more that was
(28:15):
looked at as a symptom of schizophrenia. So they would
act completely normal, be super friendly, um and very cooperative
and sort of like the writing behavior thing. When they
looked at these notes, they would indicate this cooperation or
just good sense sometimes to do things as part of
(28:36):
their problem. Um, and we'll go over a few a
few of them. It's it's shocking. Um. There was one
that lined up early for meals because I guess they
were smart enough to know, like, hey, I get at
the front of the line, I get whatever more food
or the best food, you know, the best chicken breasts.
I don't know. I saw, well, I saw it explained,
is there's not a lot else to do or anticipation reward,
(28:57):
so like that's that's something to look forward to. Yeah,
so they noted that as as an example of oral
acquisitive psychotic behavior instead of just like being hungry and bored.
Right exactly. That was that was a big recurring theme
throughout right. Yeah. This next one was really kind of funny. Um,
this one pseudo patient was talking about their marriage in
(29:20):
their home life and they said, he, you know, my
my life is pretty good. My wife and I get along.
We have occasional arguments. Um, very rarely. I spanked my kids,
which was you know, something you did back then. So
in that context, it was quote unquote normal family life. Uh.
And they said that his attempts to control emotionality with
his wife and children are punctuated by angry outbursts and
(29:42):
in the case of UH, in the case of the children, spankings.
Instead of just saying in in marriage, they exhibited behaviors
of being married, which is to say, occasionally arguing and
again in those days, like I was spanked when I
was a kid, we expect, yes I was, and now
(30:03):
it's my choice. Good for you. What was the other one?
What was the uh? Oh? So that same guy who
was trying to control emotionality with his wife. Um, they
said that. So during his interview and take interview, he
said that when he was a kid, he'd been close
to his mom but kind of distant from his father,
and then as he became an adult, he actually became
(30:24):
close friends with his father and just not quite as
close with his mom. Right, that turned into um, a
considerable ambivalence and close relationships, and that his effective stability
is absent, meaning he's emotionally unstable. Yeah, that's what they
gathered from that. You know, my brothers and sisters and me,
(30:46):
we really fought a lot when we were young. But
now that we're adults, we all get along really well. Right,
right exactly, that is psychotic. So the rosenhand goes to um,
he goes, he stops and points out, like this is
a kind of a major section in the study. He's saying, like,
this is the context of the hospital setting. This environment
(31:06):
shapes people's perceptions. And he was saying that the people's
very sane, very normal personal histories didn't affect the diagnosis
of schizophrenia. The diagnosis of schizophrenia altered everyone else's perception
of their very sane and very normal personal histories. Yeah,
and what really struck me was the Uh, and this
(31:27):
is something I think you could, like I said, you
can still see today in some cases, is the de
personalization that happened. Uh, it was kind of constant. It
seems like these patients were generally ignored. Um, this is
he Like I said, there wasn't a ton of raw data,
but there was a little bit, And one of them
was that they were close to fifteen hundred patient initiated
(31:52):
contacts with the staff, like four hundred and sixty eight times. Uh.
The eight pseudo patients went up and in aged the
staff somehow, for some reason. And apparently less than three
percent of those resulted in actual verbal engagement back to them.
So that tells me that they would just say something
to them and be ignored at the time, right, Yeah,
(32:15):
they would be ignored. They were powerless because they were
stripped of rights, they were mistreated, sometimes violently by the staff.
They were just treated like they weren't there, and they
came to kind of question their self worth just as
a part of the institutionalization process. Um. And that was
a big, big point um from this study and one
of the lasting effects that had was pointing this out. Um.
(32:38):
And like you said, I think the average length of
stay was nineteen days, The shortest stay was seven days,
the longest stay was fifty two days. Someone was digging it.
And in eleven out of twelve of these visits, the patients,
the pseudo patients were diagnosed with schizophrenia when they left,
when they were determined to be able to return to society,
(33:00):
they weren't labeled sane or cured or mentally healthy. They
were labeled as having schizophrenia in remission. And that is
what Rosenhand was talking about, that once you're labeled insane
in our society, especially in the middle of the twentieth century.
You were insane for the rest of your life. It's
just you might not be actively insane at the moment. Yeah. Absolutely,
(33:24):
So I say we take a break because, uh, we
got a pretty good twist in the story coming up,
and then we'll finish up about how this whole experiment
is viewed these days right after this, Okay, chuck sie,
(33:58):
So there's an extra twist coming. Um, Rosenhand is just
showing off at this point. He's running circles around the
field of psychiatry, juggling bowling pins that are on fire
for fun, right. Sure. Apparently somehow this word of the
study got out before the publication of the study, and
some hospital challenged Rosenhand. They said this could not possibly
(34:20):
happen at our hospital. So he actually worked with a
research hospital, um and said, Okay, the staff was informed
that over the next three months, one or more pseudo
patients was going to be admitted, and they had the
staff rate the patients that were admitted over those three
months to see if they could figure out which one
was actually faking game on. That's right. Uh So of
(34:44):
the one dred and ninety three patients that were admitted
to this hospital over a three month period, um, there
were forty one that were sniffed off the case as
pseudo patients by at least one person on the nerving staffing.
You know, they were nervous. It's the funnest staff. Uh.
(35:05):
Twenty three. Uh, we're sniffed off the case by at
least one psychiatrists, and nineteen of them were suspected by
at least a psychiatrist and at least one of the
people on the nursing staff so uh, by at least
one of the other Uh. Forty fifty sixty four of
them were suspected as being pseudo patients. And how many
(35:30):
pseudo patients did rosen Hans send their way? Zero? Not
fair trick question. He's like Wallace Shawn and the Prince's
bride all of a sudden, that's right. So yeah, he
didn't deploy any pseudo patients to the hospital and just
basically let them chase shadows to prove that not only
could they not detect false negatives, they couldn't detect false
(35:53):
positives correctly either. So in psychology they call false positives
and false negatives type one and type two errors. And
he was basically showing like psychiatry is full of judging
type one and type two errors. Yeah. I wonder if
there was one person on the staff that was trying
to talk everyone into like he's not sending any I
(36:15):
know it. I know this guy is just messing with us.
They locked that guy up and gave him powerful anti
psychotic medication. Yeah. So again, I'm sure he was very
pleased with himself after this challenge. Uh. And this is
at a time and you know I mentioned Titticut Follies earlier. Uh,
this is also a time when there was a, um,
(36:37):
you know, a lot of sort of inside looks at
what was going on in these hospitals. Thankfully because so
many of them were exposed in the early seventies. Geraldo
Rivera Uh kind of one of the first ways he
made a name for himself was, uh, the work he
did exposing the Willowbrook States School for the developmentally Disabled
on State in Island. Um. Uh, Titticut Follies. Frederick Reisman
(37:01):
um did the same thing in the late sixties, and
I think even in the eighteen hundreds, a journalist named
Nellie Blye did sort of the same thing, going undercover
to write a book called Ten Days in a Madhouse.
And then of course Kenkisi, Yeah, there's ken Kizi. Two
there was a life magazine spread from n called I
Think Bedlam forty. And all of these things like really
(37:23):
shocked the conscience of society over and over and over again,
and so together, including this wave of anti psychiatry, um,
Rosenhand's experiment with all these other things helped kind of
shape public perception and turn it against if not psychiatry itself,
certainly the large state run um depersonalizing institutions that people
(37:46):
were typically placed in when they suffered from mental illness. Yeah,
and you shouldn't be surprised to learn that John F.
Kennedy was the first president to really kind of try
and tackle this in a substantive way, um, because you know,
he very famously had mental illness in his family. They
had a lobotomy in his family, right, yeah, Rosemary. And
(38:09):
so he got on it and said, let's put it
into the guise of the federal government and get it
out of the hands of the state. That was more fat,
that was more fat tony than jfk oh mayor Quimby.
Come on, um, I know we're all frightened in Horney
one of the greatest lines ever on the citizens totally
(38:33):
uh yeah. So he said, let's let's put it under
the hands of the federal government. The state run facilities
are ignored and underfunded, and it's a it's a an
S show in there. He coined that term to uh. So,
he signed the Community Mental Health Act in nineteen sixty three,
but that was underfunded, and that was also an S show. Yeah. So,
(38:55):
so the responsibility for treating the mentally ill went from
the States to the Feds, but and the Feds never
funded that bill. So the treatment of the mentally ill
and who is responsible was basically in limbo for almost
twenty years um. And then Reagan came along and said,
how about this. We'll just push it back to the
states and we'll give them a little bit of funding,
(39:16):
but not enough. And over the years, the kind of
ping ponging between institutions and community based treatment, states responsibility
and federal responsibility, all these state run beds were closing
and closing, and there are fewer and fewer of them,
and so we end up where we are today, which
is a mixture of community based treatment, state run hospitals,
(39:39):
they're definitely still there. And then private treatment and all
of them put together is just not enough. That's why
it's so hard and so expensive to get treatment for
mental health issues today in the United States. Yeah, and
although you can't say this is the only reason, that's
one of the reason why so many people, sadly in
this country are unhoused today, including you know, veterans, military
(40:02):
veterans of the United States. And it's just reprehensible the
blind dive that has been taken over the years. In
the nineteen thirties, there was something called the Penrose hypothesis,
which basically lays most of the blame on UH imprisonment
of the mentally ill and the unhoused population that's mentally
(40:24):
ill uh squarely the feet of D institute D instante.
I can do this. You can't sound it out. D
institutionalization hooked down fun It's worked for you, man. That
is a when you look at that, that's a lot
of letters it is. It's it's a real bone head word.
I just gave myself a pat on the back. You
(40:46):
should you deserve it here you say it right now quick,
D institutionalization. You show off you've been practicing for once. Anyway,
it doesn't that doesn't mean anything. Anyone who listens to
the podcast is that me practicing has zero effect on
my pronunciation? Is true? Uh So the Penrose hypothesis lays
the blame squarely on that uh word that you just said.
(41:09):
That's very long and impressive, and you know their statistics
that helped back that up. Um. I think from eighteen
eighty to two thousand five, the percentage of people with
mental illness in prison rose from less than one percent. Yeah,
and what else about the unhoused. There's a study from
(41:30):
the mid nineties that found that the population of the
unhoused in the United States was a hundred thousand and
nineteen eighty and then in it was up to four
hundred thousand. Again, that is spans the entire um administration
of Ronald Reagan, and a lot of people lay this
at his feet. And again it's not that clear cut.
(41:51):
The Penrose hypothesis is not cut and dried. But those
are some pretty startling statistics. And the idea that if
you shut down giant state run insto tuitions and you
don't have enough treatment facilities elsewhere, what's going to happen
to those people? And it seems like a lot of
them end up on the streets or in prison, and
that's what America does with It's a large part of
(42:12):
its mentally ill population today, especially ones that are people
of color and other minorities. To absolutely. Um. As far
as Rosenhan's experiment today, how it's viewed, it's, um, why
is that funny? Anytime you say rosen Han, now, I'm
just gonna crack up. Um, it's it's a little bit
(42:34):
of a Stanford prison experiment view of it, which is, um, Hey,
this was interesting. We learned some things, but it was
not rigorous scientifically. There was no randomization, there was no control,
there was no sampling or blinding. Um, you didn't report
how you train these participants. A lot of people have
(42:55):
disregarded it, like you know, people that are well respected
in the in the commune, in any psychiatric community and
psychological community. Is nonsense and bunk um and just heavily criticized. Uh.
This one quote is I think pretty interesting. As a
neuroscientist named Seymour Ketty that uh said, this is explanation
(43:18):
if I were to drink a cord of blood and
concealing what I had done, come to the emergency room
of any hospital and vomited blood. That behavior of the
staff would be quite predictable. Uh, they would label and
treat me as having a bleeding peptic ulcer. And I
doubt that I could argue convincingly that medical science doesn't
know how to diagnose that condition. This is taking a
little far in a different direction, I think, but I
(43:40):
get the point. I saw it put a little more
succinctly by a writer in psychology today who said, the
only thing the studies showed was that it is possible
to deceive doctors by lying to them. So the study
does have as detractors if you don't share your data
like or your methodology like, it's not a scientific paper
at bait. But rosen Hands experiment has survived all these
(44:03):
years because even as detractors say, well, it did a
really good job of raising the issue of powerlessness and
deep personalization in institutions, and that, in and of itself
meat makes it a worthwhile study or paper at least
for essay. I think it's super interesting and really interesting
to read, and I think I agree. I think it
did expose a lot of things, But I don't think
(44:25):
you could, like point to it as proof of anything
necessarily except that the system was pretty messed up. Yeah,
and the system is still messed up. I mean that's
that that initial thing that already Lang hit on, that
that psychiatry treats behaviors it observes with biological medicine is
still a problem. There's a guy who used to be
the head of the National Institute of Mental Health, Thomas Insel,
(44:48):
and he said, unlike our definitions of ischemic heart disease,
lymphoma or AIDS, the D s M diagnoses are based
on a consensus about clusters of clinical symptoms, not any
objective laboratory measure. So psychiatry still finds itself in the
same place as ever, and it's now having to fend
off kind of um a turf four that's been started
by neuroscientists whore like all this stuff is brain based,
(45:10):
and we're the ones who can look into the brain.
We need to be taking over this stuff, and psychiatrists
are like nine in the in the tradition of Freud. Uh.
And also, by the way, if people listening, uh, you
said r D the initials r D laying not already laying.
If you're wondering what Howard Sterns one time sidekick comedian
(45:30):
already Lying had to do with any of this? Didn't
he hang out with Norm McDonald a lot too. Yeah,
I think they were pals, like already Lang. He had
some bad troubles for a while. I think he's doing
better now. Yeah. R I p Norm McDonald too. Yeah.
So as far as Rosenhan himself, there was a book
a few years ago and twenty nine team from Susannah
(45:51):
Cahalan unless you misspelled Callahan, No, I really wish I had,
because that's a tough one. It's probably Kahalan. Uh. It
was called The Great Pretender, And Susannah was not very
kind to rosen Han and basically said, this guy is
kind of a fraud, Like I found instances where Uh,
first of all, he didn't have that rid of habeas
(46:12):
corpus man. He said he did and told them he did,
which is really not cool. Um Uh what else, Well,
some of the data, some of the numbers that he
put out there don't match. Like she tracked one guy down,
Bill Underwood, who was a pseudo patient, and that particular
pseudo patient supposedly spent seven days in a hospital at
eight thousand patients. He actually spent eight days in a
(46:34):
hospital of fift patients, which matters if Rosenhand was saying, no,
I'm really kind of getting a random sampler, good sampling
of hospitals in America, big ones and small ones, etcetera.
If he didn't have an eight thousand patient hospital and
d was the tops, maybe that wasn't as random as
you'd think. Yeah, And she also, uh, didn't quite but
(46:55):
came close to accusing him of flat out making up
about half the people. Um, I don't know this is
because she only found three plus him uh and said, well,
maybe he made up the rest or was there like
actual evidence that he may have just made up the
rest the former But she took out a an ad
basically as an editorial in the Lancet, which is a British,
(47:18):
very respective British medical journal, um saying like, hey, I'm
looking for the other pseudo patients and got nothing, not
a single bite, not not a lead or anything. So
she wonders if actually they didn't exist. Interesting. Yeah, And
so the thing is, though it doesn't really matter, Like
even if he did make up half the data and
half the pseudo patients, it doesn't matter because this study
(47:40):
isn't based on the data. It's all about the fact
that it kind of shone this light on the way,
you know, people are treated and how the mentally ill
were treated in the United States at that time. You
got anything else, no good stuff? Nice work, thanks me,
Nice work you. If you want to know more about Rosenhand,
rosen Han, whoever, um, you can look up this article
(48:04):
on being sane and insane places all over the Internet
and I think you'll enjoy it tremendously. And since I
said that it's time for listener mail listener mail, I'm
gonna call this a couple of quick things on our
Mediacci episode. I'm not gonna read this full email, but
I did want to point this band out because listen
(48:25):
to it and they're awesome. This is from J Deptman
sent in this band MARRYATCHI l bronx Uh and they
were originally a punk band from l A And apparently
they did an acoustic set for a TV show and
they played it with a mariachi style just because it
(48:47):
had that energy and then they were like, hey, this
is awesome and that's kind of what they're known for now.
And I played some of it and it's really awesome.
And these guys, a lot of them are Caucasian and
they wear those outfits and they look awesome. Awesome. See.
But the real email I'm gonna read is uh from
Marlena Maynard. She her hers, who is a voice teacher,
(49:11):
So I imagine Marlena from Nashville knows what she's talking about. Hey, guys,
just listen to the episode about Mariaci music. I love
how you highlighted issues of class and race in the
musical and academic world. I'm a classical singer and vocal coach,
and as a professional in the field, we certainly have
a long way to go in terms of equity and diversity.
But Chuck, you mentioned that you love hearing many voices
(49:32):
singing harmony. You weren't sure if five part harmony is
a thing. Oh, I have great news, which is that
there isn't really an upper limit at all. Five part
harmony is fairly common in choral music. If the composer
wants to fill out a chord, they can simply write
another note and the members of that section will know
how to divide accordingly. You also will encounter a lot
of pieces for eight voices i e. A double choir
(49:54):
or two soprano parts to alto, to tenor and to
bass parts. Uh, and then gives an example which I
think people should check out. It's called the piece with
most parts. With the most parts that I'm aware of
is spem in ali Um by Thomas Talise Is from
the early sixteenth century. It's got forty vocal parts. Uh.
(50:18):
So just go look that up s P E M
I N A l I U M on YouTube. And
then there's a couple of more um and also lists
of bachuin um. And this is Marlena's favorite five part
choral pieces, the second movement of Yezo Mina Freida by J. S. Bach.
(50:41):
Very nice, So go check all those out. Check out
Mariachi l Bronx. You've got a great Tiny Desk concert,
among other things. Those are always fun to watch. Do
you ever see those? Yeah? I saw one when we
did the Mariotti and the Flora. I can't remember the
all all women um four piece Mariott band from New York. Yeah,
(51:01):
that's off the NPR. The Tiny Desk concert is long
been one of my favorite things. So Chuck. Since we're
talking music, though, I want to just go ahead and
give a shout out an announcement. You could say, are
you ready for this? Did your niece write an album?
Not yet, she's working on it. Um. Instead, you asked
for it and they're giving it to you. On November
(51:22):
twenty second, Diarrhea Planet is reuniting in Nashville. What's this
because of us? I probably I'm just gonna I assume
everything is because of us. No, I don't think it is,
but I want to go to that show. I bet
you that place is going to go off because they
haven't played together in three or four years now. They
broke up in two thousand eighteen. So they're going to
(51:43):
be at the Exit Inn in Nashville November twenty seconde
if you want to make a pilgrimage there. You know,
I'm looking at my calendar when it that's it's a
bad time a year Diarrhea Planet right at Thanksgiving, right
around my wife's birthday. But I've been in more trouble
in my marriage, so Nashville's pretty close. I'm going to
(52:04):
the see Stevie Nicks. Really, I'm going to see Diaria
Planet there. Emily's like, you skip my birthday to see who? Yeah?
Fantom Planet with Jason Swartzman oh Man so Chuck who
was the the original the two people who wrote in
Marlena is the vocal coach and Jay turned me onto
(52:25):
Mariachi l Bronx. That's right, Thanks Marlena and Ja. If
you want to point out some cool music we've never
heard before, we love that kind of thing. You can
send us an email to stuff podcast at iHeart radio
dot com. Stuff you Should Know is a production of
I heart Radio. For more podcasts my heart Radio, visit
the iHeart Radio app, Apple Podcasts, or wherever you listen
(52:48):
to your favorite shows.
Welcome to Stuff you Should Know, a production of I
Heart Radio. Hey, I'm welcome to the podcast. I'm Josh,
and there's Chuck and Jerry's here, capetch ng. And that
makes this a normal episode of Stuff you should Know.
That's right, the continuing bucket of Josh's obsession with psychology
(00:25):
and psychiatry. It's so interesting. I know, I love it.
These always come from you, and they're always interesting, So
let's do it. So we're talking today specifically about a
particular study, a very famous psychology study. UM. And the
whole thing is kind of rooted in context that you
have to know, which is that UM. There was a
(00:47):
time up until about the fifties when psychiatrists were considered
like unquestionable, no matter how weird or brutal or potentially
lie taking their methods were. If it was if it
was a psychiatrist saying this is needed for mental health,
then society just went along with it, right. But then
(01:11):
at some point in time there was kind of this
backlash against that because people started questioning, like, are you
sure you guys know what you're talking about? And if
you don't, UM, what you're doing is even more horrific
than we thought before. And I was trying to think
of a good analogy, Chuck, and the best I could
come up with is, let's say you gave a group
of church officials free, free reign to hunt witches, tortures
(01:37):
suspected witches, violently exercised demons from from um people who
are possessed, and then society figured out that not that
those things don't exist, but that in this case, the
church officials themselves don't exist. Right, So, in this case,
(01:59):
mental illness does exist, but the witch hunters don't aren't
actually real, their methods don't mean anything. They're completely made up.
And that was the crisis of confidence that psychiatry was
going through in the middle of the twentieth century. People
started doubting that it had any kind of veracity whatsoever,
and that they were just torturing mentally ill people to
(02:19):
try to figure it out as they went along. Yeah,
and I'm not going to get on some anti medication,
anti psychiatry soapbox, but I will say this, and you
know this about what's been going on in my private life.
But I have seen a very sad situation of someone
I love dearly in my own life over the past
few years deteriorate. Because while conditions in like let's just
(02:44):
call them asylums what they call them back then, have
certainly improved, Uh, there's still a lot of lines that
can be drawn to doctors forgetting when it comes to
mental illness, forgetting there as a human sitting there in
front of them, uh, when medication is being thrown at them.
(03:05):
And again the medication can be great, not going on
some big tirade against uh uh antipsychotic meds and things
like that. But I've just seen it happen up close
and impersonal, and it is a it is still a
very broken system in many ways, and it's really really sad. Yeah,
And what you just mentioned is it's a longstanding kind
(03:25):
of tack that psychiatry has taken, which is they're battling
the disease and the patient is just kind of an
unfortunate casualty of that battle sometimes, you know what I mean.
And so finally people stood up and said like wait, wait, wait, wait, wait,
we need to like rethink this psychiatry. Like you guys
are giving people lobotomies, You're throwing powerful um like psychotropic
(03:48):
medications at people that can rob them of their will.
Um and rob them of their personalities, like we need
to rethink this, And something called the anti psychiatry movement
started to develop, um, both in the general public and
amongst some psychiatrists and psychologists themselves, and in the Church
of scientology. Yes, scientologists hate this stuff, um, but they
(04:10):
really are kind of vehemently opposed to the entire idea,
it seems like, whereas this was more like the anti
psychiatry movement, especially within the profession, was like, Okay, our
goals are noble. What we're trying to do is worthwhile.
We just don't know what we're talking about yet, and
we need to figure out a better strategy. Yeah, And
(04:30):
as we'll see, certain things like if you listen to
our episode on Titticut Follies, things like that popped up
here and there throughout history to make people really pump
the brakes and go, wait a minute, how how are
we treating people with mental illness in this country? Like?
What the heck is going on? So there was a
a person named R. D. Lange who was um didn't
(04:54):
like to be like fully put in the box of
like anti psychiatry, but was certainly criticized and questioning the
fact that Hey, Um, we're observing these behaviors. It's a
behavioral things that we're witnessing, and we're treating them biologically,
and like, there's there's something missing here. There's a piece
that's missing. And R. D. Lange was giving a lecture
(05:18):
one time that was seen by a gentleman that we're
talking about today, David Rosenhand, who was a psychologist and
rosen Han. I guess it. You know it touched a
nerve with rosen Han or is it Rosenhand? You know
I've always said hand, Okay, Rosenhand, that's what we'll go with.
We definitely won't switch back and forth Overard. No, well,
(05:39):
we definitely won't say I'm both in secession. But Rosenhand said, Hey,
this lecture spoke to me. Um, tagging someone is mentally
ill quote unquote mentally ill is does humans a disservice
because that's a tag that they live with, not only
in the eyes of others, but to themselves, and it
(05:59):
can calls real damage. Um, and some of these people
aren't mentally ill. So we need to really take a
look at this. And I have some ideas on how
to tackle it. Yeah, and we should say in this episode,
we're going to use the word sane and insane a lot,
and nowadays you would call that healthy or mentally ill
um And the reason we're kind of using it like
(06:21):
that's number one, that's the terms they used back then.
But also it's different. It was a different understanding that
back then that there there wasn't gradiations of mental wellness.
There was you were sane or else you were insane.
And once you were insane or labeled insane, you had
that label for life. You were in remission, but you
still had that that label of you know, that you
(06:43):
carried around for the rest of your life. Yeah, that's
a good point. I'm glad you made that. Actually. Uh so.
Rosen Han also at some point previous to this, underwent
a experimental eight day in patient uh you know, and
this was rosen and wasn't like a Rosenhand there I go.
(07:03):
Wasn't saying, oh, I'm not feeling well, I'm gonna try this.
Rosenhand said all right, I'm completely saying I'm gonna check
myself in for eight days as an impatient and see
what happened. Because I want to maybe convince some of
my students to do this. After he did it, he
was like, well, that was intense. I definitely am not
going to ask my students to do this. What I'm
gonna do is design and experiment where we can have
(07:26):
non students do this and then I can tell them
what happened. Right, And the basis of it was just
one kind of very central question, right, right. So Um
Rosine haine Um decided that he was going to design
an experiment using those two experiences, and he wanted to
see if psychiatrists could do the most basic part of
(07:49):
their job, which is identify the difference between a sane
person and an insane person. Yeah, and this, it really
did make me wonder if he was influenced at all
by One Flew Over the Cuckoo's Nest. I don't know.
I saw that he started this in nineteen sixty nine.
When was that book published sixty two or sixty three.
(08:11):
It's entirely possible and was the stage play, and the
whole basis of One Flew with the Cuckoo's Nest was, Uh,
if you haven't seen the movie or read the book,
which is the both great Uh, it was it was
a gentleman who was always in trouble with the law
who basically saw a way around going to prison, and
that was, um, let me try and convince them I'm
insane and we'll be put in a cushy mental institution instead.
(08:35):
So the whole basis of that, it's a little different.
But was put a sane person in an insane asylum?
Again words they use back then, Uh, and let's see
if I can fool them. Yeah. And that was written
by Ken Kesey, who figures big time into the electric
kool aid ASCID test. And he was actually on the
ward of a state psychiatric facility in either Oregon or
(08:59):
Washington and and he like witnessed this stuff and ended
up writing a book. And he was as we'll see,
along with rosen Han man, Chuck, why did you do
that to me? Along with rosen Hand and a bunch
of other people along the years, he helped contribute to
opening society's eyes to the ills of institutionalizing the mentally
(09:21):
ill and how they were treated. Yeah. Absolutely. Um, So
rosen Han gets in there, I'm gonna say on looks
like Conomy go ahead and says, all right, here's what
I'll do. And this is all in the in the
sort of pre study like planning part. I'm gonna call
these people's pseudo patients. I'm gonna gather together people who
are what I would call perfectly saying, they've never had
(09:42):
any history of mental illness. They would go to a
psychiatric hospital and they would say, hey, I'm hearing voices. Uh.
If it was a man, they would say, I'm hearing
a man's voice. It was a woman, they would hear
a woman's voice, and it's sort of unclear what they're saying,
but I'm hearing the words uh, empty or thud or
hollow um, And I figured I should talk to someone
(10:05):
about it and let's see what happens. Yeah. And so
later people who came and have studied and analyzed this
um believed that rosenhan Was was trying to simulate existential symptoms,
possibly in existential psychosis, that where somebody has some serious
concerns about the meaning of existence all of a sudden
(10:25):
they're really concerned that they don't mean anything, that there's
no purpose to life, and that he was trying to
kind of come up with that using those words. The
thing is, after they presented themselves at the psychiatric facility
and they gave this false initial complaint. They were also
required to give a false name. They were also required
to give a false occupation because a lot of these
(10:46):
pseudo patients were actually psychologists and psychiatrists themselves, and that
would have raised red flags for sure. But also he
was worried that they would have gotten special treatment. It
would have altered the outcome of the data were collecting.
But other than that, other than those three things, the
deception ended there. They were supposed to behave exactly like
(11:07):
they normally would uh as themselves from from that point on. Yeah,
So like when they did interviews and stuff, whether it
was intake or just as they went, although we'll see
that didn't happen a lot. As they went. Uh, they
were to describe their lives as they were, uh, their
personalities as they were, their relationships, their medical history. Everything
(11:29):
was just straight up and on the straight and narrow. Um.
This is very key. They did not take the medications. Uh.
They would, you know, do the old trick where you
hide them, uh misery style and then uh and then
put them like under your mattress or something, or I
guess plush them down the toilet. Um. And they were uh.
(11:49):
And of course rosen hand is saying that, uh, it's
very natural how it happens. It's funny. Rosen And was saying, like, hey, anything,
this thing is biased in the favor of these institutions,
because like this is the very barest thing that they
should be able to tell if someone is sane or insane,
(12:12):
and these are completely sane people, so they should really
be recognized as frauds. Like this shouldn't be too hard
for them. Yeah, I mean, like, if you're presented with
somebody who has a perfectly normal, perfectly healthy life background history, um,
like yeah, you should be able to recognize him as saint.
So that was the premise of the whole thing. He
also said that they while they were in there, if
(12:33):
they were accepted into the facility, they were to become
quote paragons of cooperation. That if they were given an
instruction from somebody on the staff, they were supposed to
happily comply and follow it. Um, they were supposed to
just kind of go along and get along, not cause
any waves or any trouble. And that he noticed that
there's like a built in mechanism to kind of support
(12:54):
people from to to be uh cooperative, and that is
that they presented themselves as psychiatric patients without anyone in
these hospitals being informed that they were there, So they
had no idea when they were going to get out.
They needed to be on their best behavior and seem
as seen as possible so that they could eventually get out. Yeah,
(13:17):
and this is where it really differs from Cuckoo's Nest
because the main character there, McMurtry, was not cooperative at all,
and that you know that led to the tragic ending.
But man, yeah, what a movie. What a book. I've
never read the book is that as as good as
the movie is. It one of those rare things where
(13:37):
the movies even better than they're both great. It's it's
like a great book, great movie. Yeah, really good stuff. Um. So,
the other thing he had in his or claim to
have in his hip pocket you can put a pin in.
This is a writ of habeas corpus for each patient
in case. Uh. They just were like I gotta get
out of here, and the hospitals like, sorry, it doesn't
(13:59):
work that way. Habeas rid of habeas corpus has to
do with reporting unlawful detentions, and so rosen And said,
I've got these on hand in case anybody has to
get out. Um. And I think he presented it to
the pseudo patients that way too, right. Yeah, so don't
worry like if it if it really, if push comes
to shove, I can get you out of there through
(14:20):
the courts basically. So um. And it is really important
to know when you're voluntarily checking yourself into a mental
facility for the purposes of a deceptive study, right, um.
And one of the things that Rosenhand needed for this
study was for pseudo patients to take copious notes and
observe everything um shot down, interactions, shot down, how they
(14:42):
were treated, how other patients were treated, um, just basically
everything they could document they were supposed to document, and
Rosenhand was initially really worried that this is going to
kind of show the pseudo patients hands. So they needed
to take these notes secretly, and the pseudo patients figured
out very quickly. No one at the psychiatric facility who
(15:03):
worked there could have cared less that they were taking
notes the entire time, and in fact, they actually, in
at least one case, attributed it to their um their
psychological condition. Yeah, I mean this, um, I think it
speaks to some of the results that we'll find, which
was there a lot of time, was not a lot
(15:23):
of active participation from staff to patient. So they're like,
I don't care, he's writing big whoop, right there was
There was a note in one of their files patient
engages in writing behavior, but that was it. They didn't
think it was weird. They didn't think that whatever happened,
those patients just took notes on everything. They were insane
and so of course an insane person is going to
(15:45):
do that. And so the pseudo patients were able to
just take notes out in the open the entire time
during their stays. I think when you write engages in
and tech behavior on the end, you can make anything
like Josh and Chuck exhibited pie casting behavior right exactly
when all of a sudden, someone's coming after us. All right,
(16:06):
so the study is now designed. Um, he starts, Uh,
he's collected these pseudo patients, these volunteers, I guess, and uh,
he wants to collect data in the end. Um, we
should note that he did throw out the data from
one participant because they, I think, kept making stuff up
(16:27):
while they were in there and didn't didn't go with
the reality of their life. Um. And then another and
I have no idea why this person's data wasn't excluded.
But another person tried, and this is very McMurtry esque.
Although he hated Nurse Ratchet, but he tried to uh
to woo a nurse on the premises. Uh said that
(16:49):
he was a psychologist, and UH actually provided psychotherapy to
some other patients there. Yeah. I suspect that they didn't
throw that data out because it was Rosenhan himself. Oh,
that would be my guest. My data is still good.
I didn't think of that because he was one of
(17:11):
the eight pseudo patients at all who went to twelve
different places in this study. Very interesting. I think it's
a great place for a break. Ye. All right, I'm
gonna ponder that whole scene. Uh, and we'll be right back. Alright.
(17:44):
So it's nineteen it's funny. It was published in Science
in nineteen seventy three. But I didn't see I couldn't
find anywhere when this happened. When did it actually happen?
I saw seventy two. It's weird. I looked in a
bunch of places and it all just dived right into
the thing without saying what ear it was? Yeah, I
said I noticed that too. I found it in one place.
All right, So seventy two The Summers of Love and
(18:09):
eventually published in Science, which, of course we've talked about
it a lot. It's one of, um, if not the
most prestigious academic journal in US history. So it's not
like it was published in Popular Mechanics or something like that. Hey,
Popular Mechanics is pretty great, or BuzzFeed. Sorry, let's say
Highlights Children. Oh, I love Highlights, which is the one
(18:29):
I was on the cover of, like like Catholic Boy's
Life or something Catholic nuns like Expelled. It was spelled
n O N E apostrophees. Uh so where were we?
All right? It's nineteen seventy three. It's published in the
(18:50):
journal Science. Uh. It was called on Being Sane and
Insane Places. And it's a really great read. You sent
me in the original article. It's awesome. You can still
find it and read it. It's a really good read
because it doesn't take the form of a regular scientific
academic journal. UM doesn't have a lot of data, not
a lot of statistics, UM, not a lot of a
(19:13):
lot of things UM methodology, like results. It's just sort
of written out like this kind of uh challenge essay, which,
as we'll see, ended up. You know, therere being a
lot of problems with it, but it makes for a
much better read than most things in science. Yeah. He
starts a lot of paragraphs with oh here's another thing,
(19:34):
right Yeah. So, Um, like I said, Rosenhan was one
of the eight pseudo patients. There were eight and all, um,
five of them were men, the other three were women. Um,
and five of the eight were somehow engaged in psychology
or psychiatry plus him, are including him? Do you know?
I think I think including him? Yeah, I think he's
(19:55):
included all of those. And um. He sent them to
twelve different facilities in five different states on the East
coast and West coast. Um, and they were all different kinds.
He specifically tried to make his sample representative of the
kind of facilities that you would find throughout the United States. Yeah. Um,
one of them was a private hospital eleven where state run. Um,
(20:17):
so not the biggest division there, but they did run
the gamut from older kind of rundown places to newer places. Uh.
Some places had um really good ratios of patient staff,
some my really crutty ones uh and not nearly enough
staff uh, somewhere research based and oriented, somewhere not at all.
(20:38):
So it seems at least that he had a pretty
decent representation, right he so Um again, in the design
of his study, he has set it up to make
it as easy as possible for anyone in these psychiatric
facilities staffs to notice that, you know, this person is
actually not mentally ill at all. They're giving us all
(21:00):
this information that's contrary to that. So he he, like
he said before, Um, he biased it in favor of
the psychiatric staff finding out that these people were saying.
And he said that there were some things that he
considered and then dismissed about why they may have been admitted,
because we haven't said it yet, but all eight were
admitted in all twelve instances, Um. And one of the
(21:22):
reasons he considers they were possibly that possibly affected the
diagnosis and their mission admission was that they were nervous,
like the site of the pseudo patients were nervous about
being found out they were They were nervous they were
going to be embarrassed or shamed or maybe get into
some sort of trouble Um. And so he said that
might have contributed a little bit, but probably no, not
enough to be admitted into a psychiatric facility. So he
(21:45):
he kind of dismisses that thought. But what he says
is that they were all really surprised at how easily
they were admitted. Yeah. I mean, I think in the
late nineties sixties, when you show up say you're hearing
voices in your head, they believe you and they say,
all right, you're, uh schizophrenic, and welcome to the facility. Uh,
here's your here's your outfit, and here's your room, and uh,
(22:08):
here's your pills. And that's basically what happened. I think
they were all save one, diagnosed with schizophrenia UM. The
one was at the private run Interestingly institution, and they
were diagnosed as what would now be bipolar disorder. Back
then they called it manic depressive psychosis. But they were
(22:29):
all ushered in basically with open arms. Yeah. And I
saw and I think a big Think article on this
UM study. They pointed out that, like this is the
opposite of what it's like when you try to get
mental health treatment today. It's really hard, it's really expensive.
You don't just show up and they let you in
and here's your gown and here's your pills kind of thing.
(22:50):
So it's kind of interesting in that respect as well.
But then once these pseudo patients were in the ward again,
they have diagnoses of schizophrenia. Now, um, there wasn't a
single instance where any of their behavior was questioned by
the staff, are considered suspicious, and um he got he
obtained most of the reports from these visits and in
(23:12):
the files, there's no questioning or suspicion whatsoever about the
pseudo patients at all. No, I mean they would uh
the reports were really good, and that all the people
were like model patients and cooperating and friendly and engaging
and like. These things were noted, but no one ever
said like, uh, and we'll see you know some of them, Well,
we'll get to that point. Because I think that's one
(23:33):
of the more remarkable parts of it is how they
noted that. But what they didn't note was like, you
know what, this person doesn't seem like there's anything going
on with them at all. Uh. It was just sort
of accepted, like they're here, so this is what is
going on with them. It's really interesting. But that was
the staff, right, What about the other patients of the facility. Yeah,
(23:55):
this I think is super fascinating. They were the only
ones that were into it. The other patients they were
basically were like, you're not one of us, and I
and we can tell um and I trying to remember
in Cuckoo's Nest, I think he basically told everyone right away,
like the other patients like I don't belong here, um,
(24:16):
and he kind of became the de facto leader. But
at uh these places with rosen Han, they've they basically said, hey,
we don't think you're real. We think you're either a
journalist um, trying to expose the facility, or maybe you're
you work for the facility and you're you know, in
there as a mole kind of checking on things. Yeah exactly,
(24:38):
but either way, we don't believe you. And it seems
like in most cases they were uh. And I love
that you actually put sniffed off the case and because
you put this together, But they were sniffed off the
case generally by just being reassured by the pseudo patients
that no, I'm just feeling better, That's why I'm acting
this way, right. Can't you just see Mr Martini saying, like,
(25:00):
I know you're checking up on the hospital. So there's
the thing that Rosenhand points out, and he just kind
of brushes past it, but it's kind of important. He
says that while the other patients you know, found them
out immediately, um, none of the pseudo patients were closely
examined by the psychiatric staff, by the actual psychiatrists. They
(25:22):
had plenty of interaction with the nurses, the order lads,
you know, the people who interact with the patient's day today.
But none of them, in all twelve instances, all twelve visits,
none of them were closely examined by a psychiatrist. And
you can imagine that an inmate or a patient at
one of these facilities is going to have the opportunity
(25:42):
to really closely pay attention to you and interact with
you and see your behavior. So it might have been
easier for them just because they interacted with them more.
But he defends this, you know, potential flaw in his
design and saying like, these hospitals had plenty of opportunity
to closely examine pseudo patients and they didn't. So whether
that was the reason they didn't find them out or not,
(26:05):
it was still a huge failing of the psychiatric system
and their process, and that they didn't even closely examine
these people to see that, oh no, actually these people
are faking. Yeah. And not to harp on Cuckoo's Nest,
but it was written, you know, as a as a
real thing that Kesy did, and it was that's what
happened in that book. He you had this initial meeting
(26:26):
with a psychiatrist where they diagnosed him, and then it's like,
all right, this is where you live now, and these
are the orderlies and these are the nurses, and this
is your life. There was no regular check ins to
see if anybody was getting better, and that was the
whole point of this experiment, and in a lot of
ways was like it wasn't being done right. These people
(26:46):
were just being sent to live away because they were
a hassle for their family. They were being sent to
live somewhere else now, right. So one of the other
themes of Um one flew over the Cuckoo's Nest is that,
you know, Jack Nicholson is kind of slowly driven crazy,
I guess you could say, from being institutionalized. It was
one of the main themes um and Rosenhan Actually I
(27:08):
don't maybe he did read that book because he accounted
for this. Um. He didn't report it I think in
the study, but um in a memoir that was found
after he died. Uh. He apparently had people visit, you know,
friends visit the patients during their stay, and then would
interview the friends to see if they noticed any actual
change in the pseudo patients, and that none of them did.
(27:30):
There was no major, you know, noticeable effect of institutionalization
that could have accounted for people you know, mistaking them
as as um, you know, having schizophrenia or something. Yeah.
And this was over the course. What was the average stay?
How many weeks? I think nineteen days, almost three weeks
for the average. Yeah. So it's it's long enough to
(27:52):
where someone could have said to a visitor like, hey,
this place is really wearing on me, starting to lose
it a little bit. Uh, And apparently that didn't happen. Um.
This is the part that I think really fascinated me
was that, Uh, the more saying they were, which was
to say, uh, saying appearing um, the more that was
(28:15):
looked at as a symptom of schizophrenia. So they would
act completely normal, be super friendly, um and very cooperative
and sort of like the writing behavior thing. When they
looked at these notes, they would indicate this cooperation or
just good sense sometimes to do things as part of
(28:36):
their problem. Um, and we'll go over a few a
few of them. It's it's shocking. Um. There was one
that lined up early for meals because I guess they
were smart enough to know, like, hey, I get at
the front of the line, I get whatever more food
or the best food, you know, the best chicken breasts.
I don't know. I saw, well, I saw it explained,
is there's not a lot else to do or anticipation reward,
(28:57):
so like that's that's something to look forward to. Yeah,
so they noted that as as an example of oral
acquisitive psychotic behavior instead of just like being hungry and bored.
Right exactly. That was that was a big recurring theme
throughout right. Yeah. This next one was really kind of funny. Um,
this one pseudo patient was talking about their marriage in
(29:20):
their home life and they said, he, you know, my
my life is pretty good. My wife and I get along.
We have occasional arguments. Um, very rarely. I spanked my kids,
which was you know, something you did back then. So
in that context, it was quote unquote normal family life. Uh.
And they said that his attempts to control emotionality with
his wife and children are punctuated by angry outbursts and
(29:42):
in the case of UH, in the case of the children, spankings.
Instead of just saying in in marriage, they exhibited behaviors
of being married, which is to say, occasionally arguing and
again in those days, like I was spanked when I
was a kid, we expect, yes I was, and now
(30:03):
it's my choice. Good for you. What was the other one?
What was the uh? Oh? So that same guy who
was trying to control emotionality with his wife. Um, they
said that. So during his interview and take interview, he
said that when he was a kid, he'd been close
to his mom but kind of distant from his father,
and then as he became an adult, he actually became
(30:24):
close friends with his father and just not quite as
close with his mom. Right, that turned into um, a
considerable ambivalence and close relationships, and that his effective stability
is absent, meaning he's emotionally unstable. Yeah, that's what they
gathered from that. You know, my brothers and sisters and me,
(30:46):
we really fought a lot when we were young. But
now that we're adults, we all get along really well. Right,
right exactly, that is psychotic. So the rosenhand goes to um,
he goes, he stops and points out, like this is
a kind of a major section in the study. He's saying, like,
this is the context of the hospital setting. This environment
(31:06):
shapes people's perceptions. And he was saying that the people's
very sane, very normal personal histories didn't affect the diagnosis
of schizophrenia. The diagnosis of schizophrenia altered everyone else's perception
of their very sane and very normal personal histories. Yeah,
and what really struck me was the Uh, and this
(31:27):
is something I think you could, like I said, you
can still see today in some cases, is the de
personalization that happened. Uh, it was kind of constant. It
seems like these patients were generally ignored. Um, this is
he Like I said, there wasn't a ton of raw data,
but there was a little bit, And one of them
was that they were close to fifteen hundred patient initiated
(31:52):
contacts with the staff, like four hundred and sixty eight times. Uh.
The eight pseudo patients went up and in aged the
staff somehow, for some reason. And apparently less than three
percent of those resulted in actual verbal engagement back to them.
So that tells me that they would just say something
to them and be ignored at the time, right, Yeah,
(32:15):
they would be ignored. They were powerless because they were
stripped of rights, they were mistreated, sometimes violently by the staff.
They were just treated like they weren't there, and they
came to kind of question their self worth just as
a part of the institutionalization process. Um. And that was
a big, big point um from this study and one
of the lasting effects that had was pointing this out. Um.
(32:38):
And like you said, I think the average length of
stay was nineteen days, The shortest stay was seven days,
the longest stay was fifty two days. Someone was digging it.
And in eleven out of twelve of these visits, the patients,
the pseudo patients were diagnosed with schizophrenia when they left,
when they were determined to be able to return to society,
(33:00):
they weren't labeled sane or cured or mentally healthy. They
were labeled as having schizophrenia in remission. And that is
what Rosenhand was talking about, that once you're labeled insane
in our society, especially in the middle of the twentieth century.
You were insane for the rest of your life. It's
just you might not be actively insane at the moment. Yeah. Absolutely,
(33:24):
So I say we take a break because, uh, we
got a pretty good twist in the story coming up,
and then we'll finish up about how this whole experiment
is viewed these days right after this, Okay, chuck sie,
(33:58):
So there's an extra twist coming. Um, Rosenhand is just
showing off at this point. He's running circles around the
field of psychiatry, juggling bowling pins that are on fire
for fun, right. Sure. Apparently somehow this word of the
study got out before the publication of the study, and
some hospital challenged Rosenhand. They said this could not possibly
(34:20):
happen at our hospital. So he actually worked with a
research hospital, um and said, Okay, the staff was informed
that over the next three months, one or more pseudo
patients was going to be admitted, and they had the
staff rate the patients that were admitted over those three
months to see if they could figure out which one
was actually faking game on. That's right. Uh So of
(34:44):
the one dred and ninety three patients that were admitted
to this hospital over a three month period, um, there
were forty one that were sniffed off the case as
pseudo patients by at least one person on the nerving staffing.
You know, they were nervous. It's the funnest staff. Uh.
(35:05):
Twenty three. Uh, we're sniffed off the case by at
least one psychiatrists, and nineteen of them were suspected by
at least a psychiatrist and at least one of the
people on the nursing staff so uh, by at least
one of the other Uh. Forty fifty sixty four of
them were suspected as being pseudo patients. And how many
(35:30):
pseudo patients did rosen Hans send their way? Zero? Not
fair trick question. He's like Wallace Shawn and the Prince's
bride all of a sudden, that's right. So yeah, he
didn't deploy any pseudo patients to the hospital and just
basically let them chase shadows to prove that not only
could they not detect false negatives, they couldn't detect false
(35:53):
positives correctly either. So in psychology they call false positives
and false negatives type one and type two errors. And
he was basically showing like psychiatry is full of judging
type one and type two errors. Yeah. I wonder if
there was one person on the staff that was trying
to talk everyone into like he's not sending any I
(36:15):
know it. I know this guy is just messing with us.
They locked that guy up and gave him powerful anti
psychotic medication. Yeah. So again, I'm sure he was very
pleased with himself after this challenge. Uh. And this is
at a time and you know I mentioned Titticut Follies earlier. Uh,
this is also a time when there was a, um,
(36:37):
you know, a lot of sort of inside looks at
what was going on in these hospitals. Thankfully because so
many of them were exposed in the early seventies. Geraldo
Rivera Uh kind of one of the first ways he
made a name for himself was, uh, the work he
did exposing the Willowbrook States School for the developmentally Disabled
on State in Island. Um. Uh, Titticut Follies. Frederick Reisman
(37:01):
um did the same thing in the late sixties, and
I think even in the eighteen hundreds, a journalist named
Nellie Blye did sort of the same thing, going undercover
to write a book called Ten Days in a Madhouse.
And then of course Kenkisi, Yeah, there's ken Kizi. Two
there was a life magazine spread from n called I
Think Bedlam forty. And all of these things like really
(37:23):
shocked the conscience of society over and over and over again,
and so together, including this wave of anti psychiatry, um,
Rosenhand's experiment with all these other things helped kind of
shape public perception and turn it against if not psychiatry itself,
certainly the large state run um depersonalizing institutions that people
(37:46):
were typically placed in when they suffered from mental illness. Yeah,
and you shouldn't be surprised to learn that John F.
Kennedy was the first president to really kind of try
and tackle this in a substantive way, um, because you know,
he very famously had mental illness in his family. They
had a lobotomy in his family, right, yeah, Rosemary. And
(38:09):
so he got on it and said, let's put it
into the guise of the federal government and get it
out of the hands of the state. That was more fat,
that was more fat tony than jfk oh mayor Quimby.
Come on, um, I know we're all frightened in Horney
one of the greatest lines ever on the citizens totally
(38:33):
uh yeah. So he said, let's let's put it under
the hands of the federal government. The state run facilities
are ignored and underfunded, and it's a it's a an
S show in there. He coined that term to uh. So,
he signed the Community Mental Health Act in nineteen sixty three,
but that was underfunded, and that was also an S show. Yeah. So,
(38:55):
so the responsibility for treating the mentally ill went from
the States to the Feds, but and the Feds never
funded that bill. So the treatment of the mentally ill
and who is responsible was basically in limbo for almost
twenty years um. And then Reagan came along and said,
how about this. We'll just push it back to the
states and we'll give them a little bit of funding,
(39:16):
but not enough. And over the years, the kind of
ping ponging between institutions and community based treatment, states responsibility
and federal responsibility, all these state run beds were closing
and closing, and there are fewer and fewer of them,
and so we end up where we are today, which
is a mixture of community based treatment, state run hospitals,
(39:39):
they're definitely still there. And then private treatment and all
of them put together is just not enough. That's why
it's so hard and so expensive to get treatment for
mental health issues today in the United States. Yeah, and
although you can't say this is the only reason, that's
one of the reason why so many people, sadly in
this country are unhoused today, including you know, veterans, military
(40:02):
veterans of the United States. And it's just reprehensible the
blind dive that has been taken over the years. In
the nineteen thirties, there was something called the Penrose hypothesis,
which basically lays most of the blame on UH imprisonment
of the mentally ill and the unhoused population that's mentally
(40:24):
ill uh squarely the feet of D institute D instante.
I can do this. You can't sound it out. D
institutionalization hooked down fun It's worked for you, man. That
is a when you look at that, that's a lot
of letters it is. It's it's a real bone head word.
I just gave myself a pat on the back. You
(40:46):
should you deserve it here you say it right now quick,
D institutionalization. You show off you've been practicing for once. Anyway,
it doesn't that doesn't mean anything. Anyone who listens to
the podcast is that me practicing has zero effect on
my pronunciation? Is true? Uh So the Penrose hypothesis lays
the blame squarely on that uh word that you just said.
(41:09):
That's very long and impressive, and you know their statistics
that helped back that up. Um. I think from eighteen
eighty to two thousand five, the percentage of people with
mental illness in prison rose from less than one percent. Yeah,
and what else about the unhoused. There's a study from
(41:30):
the mid nineties that found that the population of the
unhoused in the United States was a hundred thousand and
nineteen eighty and then in it was up to four
hundred thousand. Again, that is spans the entire um administration
of Ronald Reagan, and a lot of people lay this
at his feet. And again it's not that clear cut.
(41:51):
The Penrose hypothesis is not cut and dried. But those
are some pretty startling statistics. And the idea that if
you shut down giant state run insto tuitions and you
don't have enough treatment facilities elsewhere, what's going to happen
to those people? And it seems like a lot of
them end up on the streets or in prison, and
that's what America does with It's a large part of
(42:12):
its mentally ill population today, especially ones that are people
of color and other minorities. To absolutely. Um. As far
as Rosenhan's experiment today, how it's viewed, it's, um, why
is that funny? Anytime you say rosen Han, now, I'm
just gonna crack up. Um, it's it's a little bit
(42:34):
of a Stanford prison experiment view of it, which is, um, Hey,
this was interesting. We learned some things, but it was
not rigorous scientifically. There was no randomization, there was no control,
there was no sampling or blinding. Um, you didn't report
how you train these participants. A lot of people have
(42:55):
disregarded it, like you know, people that are well respected
in the in the commune, in any psychiatric community and
psychological community. Is nonsense and bunk um and just heavily criticized. Uh.
This one quote is I think pretty interesting. As a
neuroscientist named Seymour Ketty that uh said, this is explanation
(43:18):
if I were to drink a cord of blood and
concealing what I had done, come to the emergency room
of any hospital and vomited blood. That behavior of the
staff would be quite predictable. Uh, they would label and
treat me as having a bleeding peptic ulcer. And I
doubt that I could argue convincingly that medical science doesn't
know how to diagnose that condition. This is taking a
little far in a different direction, I think, but I
(43:40):
get the point. I saw it put a little more
succinctly by a writer in psychology today who said, the
only thing the studies showed was that it is possible
to deceive doctors by lying to them. So the study
does have as detractors if you don't share your data
like or your methodology like, it's not a scientific paper
at bait. But rosen Hands experiment has survived all these
(44:03):
years because even as detractors say, well, it did a
really good job of raising the issue of powerlessness and
deep personalization in institutions, and that, in and of itself
meat makes it a worthwhile study or paper at least
for essay. I think it's super interesting and really interesting
to read, and I think I agree. I think it
did expose a lot of things, But I don't think
(44:25):
you could, like point to it as proof of anything
necessarily except that the system was pretty messed up. Yeah,
and the system is still messed up. I mean that's
that that initial thing that already Lang hit on, that
that psychiatry treats behaviors it observes with biological medicine is
still a problem. There's a guy who used to be
the head of the National Institute of Mental Health, Thomas Insel,
(44:48):
and he said, unlike our definitions of ischemic heart disease,
lymphoma or AIDS, the D s M diagnoses are based
on a consensus about clusters of clinical symptoms, not any
objective laboratory measure. So psychiatry still finds itself in the
same place as ever, and it's now having to fend
off kind of um a turf four that's been started
by neuroscientists whore like all this stuff is brain based,
(45:10):
and we're the ones who can look into the brain.
We need to be taking over this stuff, and psychiatrists
are like nine in the in the tradition of Freud. Uh.
And also, by the way, if people listening, uh, you
said r D the initials r D laying not already laying.
If you're wondering what Howard Sterns one time sidekick comedian
(45:30):
already Lying had to do with any of this? Didn't
he hang out with Norm McDonald a lot too. Yeah,
I think they were pals, like already Lang. He had
some bad troubles for a while. I think he's doing
better now. Yeah. R I p Norm McDonald too. Yeah.
So as far as Rosenhan himself, there was a book
a few years ago and twenty nine team from Susannah
(45:51):
Cahalan unless you misspelled Callahan, No, I really wish I had,
because that's a tough one. It's probably Kahalan. Uh. It
was called The Great Pretender, And Susannah was not very
kind to rosen Han and basically said, this guy is
kind of a fraud, Like I found instances where Uh,
first of all, he didn't have that rid of habeas
(46:12):
corpus man. He said he did and told them he did,
which is really not cool. Um Uh what else, Well,
some of the data, some of the numbers that he
put out there don't match. Like she tracked one guy down,
Bill Underwood, who was a pseudo patient, and that particular
pseudo patient supposedly spent seven days in a hospital at
eight thousand patients. He actually spent eight days in a
(46:34):
hospital of fift patients, which matters if Rosenhand was saying, no,
I'm really kind of getting a random sampler, good sampling
of hospitals in America, big ones and small ones, etcetera.
If he didn't have an eight thousand patient hospital and
d was the tops, maybe that wasn't as random as
you'd think. Yeah, And she also, uh, didn't quite but
(46:55):
came close to accusing him of flat out making up
about half the people. Um, I don't know this is
because she only found three plus him uh and said, well,
maybe he made up the rest or was there like
actual evidence that he may have just made up the
rest the former But she took out a an ad
basically as an editorial in the Lancet, which is a British,
(47:18):
very respective British medical journal, um saying like, hey, I'm
looking for the other pseudo patients and got nothing, not
a single bite, not not a lead or anything. So
she wonders if actually they didn't exist. Interesting. Yeah, And
so the thing is, though it doesn't really matter, Like
even if he did make up half the data and
half the pseudo patients, it doesn't matter because this study
(47:40):
isn't based on the data. It's all about the fact
that it kind of shone this light on the way,
you know, people are treated and how the mentally ill
were treated in the United States at that time. You
got anything else, no good stuff? Nice work, thanks me,
Nice work you. If you want to know more about Rosenhand,
rosen Han, whoever, um, you can look up this article
(48:04):
on being sane and insane places all over the Internet
and I think you'll enjoy it tremendously. And since I
said that it's time for listener mail listener mail, I'm
gonna call this a couple of quick things on our
Mediacci episode. I'm not gonna read this full email, but
I did want to point this band out because listen
(48:25):
to it and they're awesome. This is from J Deptman
sent in this band MARRYATCHI l bronx Uh and they
were originally a punk band from l A And apparently
they did an acoustic set for a TV show and
they played it with a mariachi style just because it
(48:47):
had that energy and then they were like, hey, this
is awesome and that's kind of what they're known for now.
And I played some of it and it's really awesome.
And these guys, a lot of them are Caucasian and
they wear those outfits and they look awesome. Awesome. See.
But the real email I'm gonna read is uh from
Marlena Maynard. She her hers, who is a voice teacher,
(49:11):
So I imagine Marlena from Nashville knows what she's talking about. Hey, guys,
just listen to the episode about Mariaci music. I love
how you highlighted issues of class and race in the
musical and academic world. I'm a classical singer and vocal coach,
and as a professional in the field, we certainly have
a long way to go in terms of equity and diversity.
But Chuck, you mentioned that you love hearing many voices
(49:32):
singing harmony. You weren't sure if five part harmony is
a thing. Oh, I have great news, which is that
there isn't really an upper limit at all. Five part
harmony is fairly common in choral music. If the composer
wants to fill out a chord, they can simply write
another note and the members of that section will know
how to divide accordingly. You also will encounter a lot
of pieces for eight voices i e. A double choir
(49:54):
or two soprano parts to alto, to tenor and to
bass parts. Uh, and then gives an example which I
think people should check out. It's called the piece with
most parts. With the most parts that I'm aware of
is spem in ali Um by Thomas Talise Is from
the early sixteenth century. It's got forty vocal parts. Uh.
(50:18):
So just go look that up s P E M
I N A l I U M on YouTube. And
then there's a couple of more um and also lists
of bachuin um. And this is Marlena's favorite five part
choral pieces, the second movement of Yezo Mina Freida by J. S. Bach.
(50:41):
Very nice, So go check all those out. Check out
Mariachi l Bronx. You've got a great Tiny Desk concert,
among other things. Those are always fun to watch. Do
you ever see those? Yeah? I saw one when we
did the Mariotti and the Flora. I can't remember the
all all women um four piece Mariott band from New York. Yeah,
(51:01):
that's off the NPR. The Tiny Desk concert is long
been one of my favorite things. So Chuck. Since we're
talking music, though, I want to just go ahead and
give a shout out an announcement. You could say, are
you ready for this? Did your niece write an album?
Not yet, she's working on it. Um. Instead, you asked
for it and they're giving it to you. On November
(51:22):
twenty second, Diarrhea Planet is reuniting in Nashville. What's this
because of us? I probably I'm just gonna I assume
everything is because of us. No, I don't think it is,
but I want to go to that show. I bet
you that place is going to go off because they
haven't played together in three or four years now. They
broke up in two thousand eighteen. So they're going to
(51:43):
be at the Exit Inn in Nashville November twenty seconde
if you want to make a pilgrimage there. You know,
I'm looking at my calendar when it that's it's a
bad time a year Diarrhea Planet right at Thanksgiving, right
around my wife's birthday. But I've been in more trouble
in my marriage, so Nashville's pretty close. I'm going to
(52:04):
the see Stevie Nicks. Really, I'm going to see Diaria
Planet there. Emily's like, you skip my birthday to see who? Yeah?
Fantom Planet with Jason Swartzman oh Man so Chuck who
was the the original the two people who wrote in
Marlena is the vocal coach and Jay turned me onto
(52:25):
Mariachi l Bronx. That's right, Thanks Marlena and Ja. If
you want to point out some cool music we've never
heard before, we love that kind of thing. You can
send us an email to stuff podcast at iHeart radio
dot com. Stuff you Should Know is a production of
I heart Radio. For more podcasts my heart Radio, visit
the iHeart Radio app, Apple Podcasts, or wherever you listen
(52:48):
to your favorite shows.
Stuff You Should Know News
Hosts And Creators
Chuck Bryant
Josh Clark
Show Links
AboutOrder Our BookStoreSYSK ArmyRSSPopular Podcasts
40s and Free Agents: NFL Draft Season
Daniel Jeremiah of Move the Sticks and Gregg Rosenthal of NFL Daily join forces to break down every team's needs this offseason.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
The Bobby Bones Show
Listen to 'The Bobby Bones Show' by downloading the daily full replay.