The Fraud That Transformed Psychiatry Series, Transcript P19

Shidonna Raven
Mar 4
3 min read

July 23, 2024

Source: The Scince History Institute

Photo / Image Source: Unsplash,

Host: Alexis Pedrick

Senior Producer: Mariel Carr

Producer: Rigoberto Hernandez

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

Alexis Pedrick: The obvious question is, why? Why didn’t he kill the study he hated when he had the chance?

Susannah Cahalan: I think that Spitzer saw the study as an opportunity because it was going to, and it did, really raise the way, you know, how psychiatry was done. It was kind of gonna implode it, and it was needed to start again, and, and Spitzer had a new vision for how psychiatry was going to go. It was gonna be the DSM III, it was gonna be this kind of document of symptoms that would be filled in over time with biology. And biochemistry and neurology, not biology, but biochemistry and neurology. It was going to be a document that was going to describe symptoms and be extremely diagnostic. And it was going to swing completely away from psychoanalysis. And this study would help that happen. Because it would embarrass the field so badly that they would cling to anything that had any kind of scientific bent to it. And he was ultimately, like, the best person to bring that forward. And so I think he used it to bring about the ends that he, that he ultimately wanted was to, which was to launch DSM III in a big way and change psychiatry forever, which it did.

Alexis Pedrick: So in the end, both David Rosenhan and Robert Spitzer got what they wanted, the asylums closed. And in 1980 we got a new DSM, the DSM III. Now, the DSM III did make the problem of consistency in diagnosis better. Unfortunately, it didn’t bring us any closer to understanding the causes of mental illness. Spitzer had a vision for where psychiatry was going, and it was biological. It was going to be built on real hard science, just like any other branch of medicine. And even though neuroscience has come leaps and bounds since 1980, it sadly still hasn’t brought much clarity to psychiatric diagnoses.

Andrew Scull: There were lots of family studies that said, Look, mental illness runs in families. Surely we’re going now to be able to discover what the genetic origins of mental illness are. Except, we haven’t been able to do that.

Alexis Pedrick: Susannah Cahalan did fulfill her goal of meeting a pseudopatient from the study and finding out how it impacted him. Bill Underwood left psychiatry, but he and David Rosenhan remained friends for a long time after the study was over.

Bill Underwood: Yeah, we stayed in touch. I would be, uh, out in the Bay Area from time to time, and we would often get together for lunch and have various discussions about, uh, uh, our children and how they were doing. And, and because we had known his children, he had known our children when, when I was a grad student there and he was on the faculty.

Alexis Pedrick: He’s skeptical of the conclusion Susannah came to in her book.

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