The Fraud That Transformed Psychiatry Series, P2

Shidonna Raven
Apr 30
4 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

Alexis Pedrick: In 1973, a bombshell study appeared in the premier scientific journal, Science. It was called, “On Being Sane in Insane Places.”

Archived Audio of Dr. Rosenhan in Conversation: Dr. Rosenhan, you did a study and in the study you got yourself committed to an institution, a mental institution. How did you get them to believe that you were, you were mentally ill or that you had an emotional problem? What it really amounted to was faking a set of symptoms. Did the doctors ever catch on? Never.

Alexis Pedrick: Does that sound as wild to you as it did to me? Let’s go back to the beginning. In 1969, at Swarthmore College, just outside of Philadelphia, there was a beloved psychology professor named David Rosenhan. He was known for his tweed jackets with elbow patches, his large bald head, and his deep authoritative lecture voice. This is Susannah Cahalan, the author of a book about him called The Great Pretender.

Susannah Cahalan: Rosenhan, you know, he was this raconteur, he was funny, and he had this great voice, and he could command a room, and people really loved him, really gravitated towards him.

Alexis Pedrick: But one day, a group of undergraduate students visited him in his smoky basement lab to complain. They were taking his abnormal psychology seminar, and it was too abstract. How would they ever really understand mental illness without any real-world encounters?

Archived Audio of Dr. Rosenhan in Conversation: This whole thing began when I was planning to bring in an undergraduate seminar in a hospital to give them some sense of what schizophrenics are really like and what patients are really like. Let’s not talk about them, let’s not go visit them, let’s go live with them for a while.

Alexis Pedrick: That was David Rosenhan, speaking to an NPR reporter on stage at an American Psychological Association convention in 1982. And, yes, his idea was that the students would get themselves admitted to psychiatric hospitals, secretly, by pretending to have a mental illness. But first, Rosenhan had to prepare his students. He got them acquainted with the work of academics and journalists who had gone undercover in psychiatric hospitals, and there was a common theme to their reporting. Probably the nicest way to say it is that they had an unfavorable view of mental institutions. You see, psychiatry had gone through a boom time in the post-World War II years. Freudian psychoanalysis was all the rage. Mental asylums reached their peak numbers, and the first anti-psychotic drug, Thorazine, was hailed as a rare breakthrough.

Madness and Medicine Archival: Thorazine, the first of the major tranquilizers, was given to several million patients within months of its introduction. The drugs couldn’t have come at a better time. Patient populations were rising and the drugs promised to slow that growth.

Alexis Pedrick: But by the 1960s, the backlash had arrived. This is sociologist Andrew Scull, the author of several books about psychiatry.

Andrew Scull: There’d arisen a growing skepticism among intellectuals about psychiatry, what now we tend to call anti psychiatry.

Alexis Pedrick: In 1961, a Hungarian American psychoanalyst named Thomas Szasz made waves for criticizing his own profession.

Andrew Scull: And he wrote a book called The Myth of Mental Illness, in which he said, you know, mental illness is a myth. This is a creation of the profession.

Titicut Follies: You, you looked at me and you tell me I’m a schizophrenic paranoia. I, how, just how do you know? Because, because I speak well, because, uh, because I, I stand up for what I, what I think. Because you get, because you get the psychological testings.

Alexis Pedrick: And it wasn’t just books. In 1967, Frederick Wiseman’s film, Titicut Follies, documented life at a hospital for the, quote, criminally insane, and provided evidence for Thomas Szasz’s arguments against forcible psychiatric treatment.

Titicut Follies: May I ask just why I need this help that I, uh, that you are literally…

Alexis Pedrick: The growing anti psychiatry movement went hand in hand with the civil rights movement, and was embraced by the growing counterculture of the decade. People started asking, ‘was labeling someone as mentally ill just a way of singling out difference, or of calling out nonconformity?’

Andrew Scull: And then there was, within my own profession, and my colleague briefly, while I was at the University of Pennsylvania, Irving Goffman, and Goffman had written a book in 1961 called Asylums, in which he compared mental hospitals to concentration camps and prisons. And he said that the mental hospital was something that dehumanized people, that destroyed them, that damaged their ability to act as autonomous people and, in effect, sort of manufactured madness.

Alexis Pedrick: Everything Rosenhan assigned to his students describes psychiatric hospitals as authoritarian, degrading, and illness maintaining. So it’s pretty clear what he expected them to find when they got themselves admitted.

Archived Audio of Dr. Rosenhan in Conversation: But before I did that, it seemed reasonable that I should do it first.

Alexis Pedrick: That’s right, David Rosenhan got himself covertly admitted to a psychiatric hospital. And what followed in the wake was, to use a colloquialism, completely bananas. His undercover mission grew. It became a scientific study that the prestigious journal Science published in 1973. And it changed psychiatry forever. From the Science History Institute, I’m Alexis Patrick, and this is Distillations.

The Myth of Mental Illness: Foundations of a Theory of Personal Conduct

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