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The Fraud That Transformed Psychiatry Series, Transcript P16



July 23, 2024

Photo / Image Source: Unsplash,


Senior Producer: Mariel Carr



Associate Producer: Sarah Kaplan


Audio Engineer: Jonathan Pfeffer


“Color Theme” composed by Jonathan Pfeffer. Additional music by Blue Dot Sessions



Psychology professor David Rosenhan made waves with his “On Being Sane in Insane Places” study, but decades later its legitimacy was questioned.

WFGD Studio


Transcript

Susannah Cahalan: I didn’t have any radar about this. I wasn’t like, oh, I’m going to unmask this. You know, I’m going to figure out the truth. It was more like, who would do this and why? And how did it affect the rest of their lives?

Alexis Pedrick: After the book came out, Susannah went out to dinner with two of the people who knew David best, two psychologists named Florence Keller and Lee Ross. 

Susannah Cahalan: She was the one who said to me, maybe he made this all up. And also, you know, Lee Ross is this great kind of giant in psychology, so insightful and smart. And he was pretty convinced Rosenhan had at least fabricated parts of the, of his study. I mean, I think that’s undeniable. The question is how much really. 

Alexis Pedrick: Chapter Four. The Aftermath. 

Archived Audio of Dr. Rosenhan in Conversation: Do you think that Asians can, can get better going into institutions today as they are in this country? I really don’t. By and large, I think that psychiatric hospitals are non-therapeutic and would look forward to their being closed.

Alexis Pedrick: Psychiatric hospitals reached their peak numbers in 1955 and then gradually started declining into the ‘60s before Rosenhan’s study. 

Susannah Cahalan: What happened with Rosenhan is it started the process of uniting left and right over this issue. You have this kind of financial perspective of, well, we’ll save money by closing these hospitals. Then you have this patient rights perspective of people shouldn’t be there.

Archived Audio of Dr. Rosenhan in Conversation: If you’re saying that mental institutions are not good places for people with emotional or mental problems to be, what can we do to help people with problems? You’ve got me over a barrel, Carol. I’m not sure. It’s so much easier to say no about something than to say yes. 

Alexis Pedrick: But Rosenhan did have a prime example of how a psychiatric facility could be therapeutic, in Harry Lando’s experience.

Harry Lando: And I guess that’s where now I would really resent Rosenhan because he painted this incredibly negative picture and the reality is that in general, that was accurate, but to fail to recognize the exceptions and that there were places that were really good was an incredible lost opportunity, and I think it’s had major repercussions.

Alexis Pedrick: Rosenhan got his wish. Psychiatric hospitals closed, and for a lot of them, it was good riddance. 

Susannah Cahalan: They should have disappeared because these were horrible places, but what was left was just kind of an emptiness. You know, what do you do now? 

Alexis Pedrick: When asylums were closed, they were supposed to be replaced by a model called community care, and in theory, it’s great. Everyone who needs psychiatric care can get it while living in their own community, but it never really materialized. And today, the major centers of inpatient psychiatry in the U.S. are in prisons. But it wasn’t just the asylum system that felt the impact of the study. It prompted psychiatrists to completely change their system of diagnosing. They set out to revise psychiatry’s bible, the book that categorizes mental illness. It’s called the Diagnostic and Statistical Manual of Mental Disorders, or the DSM. There had already been two versions, now they needed another one. 



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