The Fraud That Transformed Psychiatry Series, Transcript P7

Shidonna Raven
May 22
5 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

Archived Audio of Dr. Rosenhan in Conversation: My father and I weren’t such good friends when I was a kid, but he was my best friend during my adolescence and early adulthood until he died.

Alexis Pedrick: “His attempts to control emotionality are punctuated by angry outbursts and spankings.”

Archived Audio of Dr. Rosenhan in Conversation: Do you ever spank your children? To which I responded, my son twice, my daughter once, in fact. He never inquired under what conditions do you spank your children, or did you spank your children? What becomes very interesting is how they interpret it. So you take this, what I consider to be unexceptional case history, uh, was interpreted as reflecting my enormous ambivalence in interpersonal relationships.

Alexis Pedrick: This excerpt from Rosenhan’s medical record was used in the Science article as evidence that once someone was inside the walls of a mental institution, psychiatrists were primed to see mental illness. There was just one problem.

Susannah Cahalan: So you have a whole part that is supposedly word for word from the medical record. It was very Freudian. It was psychoanalytic. It was about the father and the mother and this relationship, and it was entirely made up.

Alexis Pedrick: Susannah had David Rosenhan’s actual medical record. And after the wig revelation, she looked more closely at it. It revealed the hospital where he’d been, Haverford State Hospital. And at first, it tracks with the symptoms every pseudo patient was supposed to claim. But then Rosenhan went off script. Way off.

Susannah Cahalan: I found the medical record that Rosenhan had said things like, I put copper pots over my ears to drown out the noises, and that he had been suicidal for many months. I mean, these are very serious symptoms.

Alexis Pedrick: “He has felt that he is sensitive to radio signals and hear what people are thinking. He realized that these experiences are unreal, but cannot accept their reality. One reason for coming to the hospital was because things are quote, ‘better insulated in a hospital.’”

Susannah Cahalan: These are very serious symptoms, and understandably, a psychiatrist looking at it would be concerned. And, you know, even psychiatrists that I showed today, they said the suicidality would be an issue. That there’s such a crisis in mental health care, they probably wouldn’t get a bed. But if there was a bed available, maybe he would have gotten a bed today. The suicidality thing really shocked me.

Alexis Pedrick: None of these details made it into the article itself, or any of the scores of lectures or interviews Rosenhan gave after the Science article was published.

Susannah Cahalan: It was a fiction, it was a fantasy that, that, that, that Rosenhan made up, and he published it in Science. And it was shocking to me.

Alexis Pedrick: Finding the real medical report gave Susannah a whole new level of skepticism about the study, and she realized something else was off.

Susannah Cahalan: Almost every detail in the article was about David Rosenhan’s time in the hospital from his Haverford State Hospital visit in ‘69. And I know that because I had his notes from Haverford. And, oh, there are almost no other details about the other seven. However, there were still some details about Harry’s hospitalization that were used in the study, one involving flirting with a nurse.

Harry Lando: He kind of had it both ways because I was a footnote, I wasn’t included, but there were several references in the article to what was very clearly my experience.

Alexis Pedrick: Remember, Harry’s data was dropped from the study because it didn’t fit Rosenhan’s thesis.

Susannah Cahalan: But Harry made it in? Wouldn’t you think he’d have enough detail from the other six to not have to use the one he claims to have discarded? That really kind of pinged something in me, and I really started to look at the archive and the information that it had in a different light.

Alexis Pedrick: Throughout the years she worked on her book, Susannah tried over and over again to identify the other six pseudopatients. She wrote to medical journals looking for people who knew anything. She made a speech at an American Psychiatric Association meeting. She even hired a private detective and the only two pseudopatients any of these efforts ever pointed to were Bill Underwood and Harry Lando. Still, Susannah held out hope that someone would read the book and come forward. But the book came out in 2019.

Susannah Cahalan: No one’s come forward. Like, someone would’ve, and now I’ve completely given it up because the book’s come out.

Alexis Pedrick: We may never know definitively if there were any other pseudo patients besides David Rosenhan, Bill Underwood, and Harry Lando and his footnote. But here’s what we do know. David Rosenhan attended a conference in 1970 where an editor from Science was also present.

Susannah Cahalan: And I believe, this is conjecture, but I believe that’s where science got their knowledge about this and said to him, make this into a study, add some other people into this, and we’ll publish this. That’s my theory. And I think he had a harder time convincing people to get to do that than he thought he would. And I think kind of it was down to the wire, and he was putting a lot of pressure. Harry remembers that he was putting a lot of pressure on the students to take part in the study, and people really didn’t want a lot to do with it. And I think he was kind of back against the wall and either he delivered or he didn’t.

Alexis Pedrick: After the Science article came out, Rosenhan got offered a book deal.

Susannah Cahalan: The big book was the next step to really cement your legacy. He got a deal. He paid part of his advance. And he never delivered the book. So I had the book. It was almost, I would say, three quarters the way done, maybe, maybe a little bit less.

Alexis Pedrick: It was here, in the unfinished book, where Susannah found all the details about the other pseudopatients.

Susannah Cahalan: Now this is an interesting part. So the detailed notes seemed to come while he was writing the book.

Alexis Pedrick: That is, after the study came out.

Susannah Cahalan: Interestingly, the other pseudopatients, though there were tons of details, all of them felt off. It didn’t feel real. The parts that felt real really were David’s own experience. That was really kind of jumped off the page and, and really kind of shined, but the rest just really did not make much sense.

Alexis Pedrick: One of the pseudopatients was described as a famous abstract painter, the only one admitted to a private psychiatric facility. But Susannah started pulling one thread from Rosenhan’s notes about her, and it quickly came apart. First, Rosenhan claimed that he paid for the stay himself, but she was supposedly there for 53 days, which would have been extremely expensive.

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