– WHO’S CRAZY? –
A bizarre experiment in the United States has demonstrated that psychiatrists cannot distinguish effectively between people who are mentally ill and those who are not. According to its originators, the experiment demonstrates that the conventional psychiatric diagnosis may not be perfect and psychiatrists may sometimes make mistakes.
The experiment also lends considerable support to the position taken by radical psychiatrists like R.D. Laing, who argue that diagnoses of mental disease are often no more than convenient labels designed to make life easier for doctors. Eight perfectly normal people, by shamming symptoms of a mild kind, successfully gained admission to psychiatric wards where they remained undetected during their stay.
Who is crazy?
Once admitted, their behaviour was normal in every way. They stopped pretending and behaved as normally as they could, but doctors and nurses continued to treat them as disturbed. In every case but one the diagnosis was schizophrenia.
Once they were labelled as mentally ill, everything the ‘pseudo-patients’ did tended to confirm the diagnosis in the eyes of the medical staff, though other patients in the hospital were much less easy to convince. To gain admission, the pseudo-patients told the whole truth about their lives, their emotions and their personal relationships – all of which were within the normal range – and lied only about their names, symptoms, and in some cases their occupations.
The symptoms they complained of were hearing disembodied voices saying the words ’empty’, ‘hollow’ and ‘thud’. This was sufficient in every case for them to be classified as mentally ill and admitted to the hospital.
As many as a third of the real patients inside detected that they were frauds.
‘You’re not crazy. You’re a journalist or a professor. You’re checking up on the hospital,’ was typical comment from a real patient. The experiment was carried out under the supervision of Professor D.L. Rosenhan of Stanford University, himself one of the eight pseudo-patients.
Writing about the experiment in this week’s Science, he concludes: “We cannot distinguish mentally ill people from sane people in mental hospitals How many people, one wonders, are sane but not recognised as sans in our psychiatric institutions?.,..
How many have been stigmatised by well-intentioned, but nevertheless erroneous, diagnoses?” In Professor Rosenhan’s view, the hospital itself is an environment that distorts judgement. As evidence, he quotes what happened to the patients who asked doctors perfectly sensible questions. They took the form: “Pardon me, Dr. X, could you tell me when I will be eligible for ground privileges?” – or some similar request, courteously presented. In , almost three-quarters of the cases the psychiatrist’s response was to walk on, looking away.
Only one doctor in stopped and tried to answer the question. But the clinching piece of evidence comes from another experiment in which a hospital was warned that pseudo-patients would be presenting themselves. Faced with this threat to their professional reputation, the doctors admitting patients became much more conservative in their diagnoses.
Of 193 patients presenting themselves, one doctor was firmly convinced that 41 were frauds, while another doctor suspected 23. In fact, no pseudo-patients had arrived at all.
Mark the best choice.
1. Line 6, ‘lends considerable support to* means .
a) helps for a short time b) argues against c) helps to prove d) disproves i
2. Line 10, ‘shamming’ means . a) pretending to have b) having c) catching d) discussing
3. Lines 14-15, ‘continued to treat them as disturbed’ means .
a) gave them a difficult time
b) went on behaving towards them as if they were mentally ill
c) had an unusual attitude towards them
d) treated them in a strange way
4. Line 17, ‘pseudo-patients’ means
a) real patients
b) mental patients
c) people pretending to be patients
d) people with the diagnosis of schizophrenia
5. The experimenters managed to get admitted to mental hospitals by
a) telling the whole truth about their emotional problems
b) telling lies about their occupations and names
c) saying that they heard voices saying words
d) behaving as normally as they could
6. Line 27, they’ refers to .
a) the experimenters
b) the real patients
c) a third of the real patients
d) the medical staff
7. Line 33, ‘We’ refers to .
a) the public in general b) psychiatrists c) mental patients d) pseudo-patients
8. Why did the experimenters ask the doctors perfectly sensible questions’?
a) to prove that they were not mad
b) to see what the doctors would do
c) to ask for information
d) because they were bored
9. When the experimenters asked perfectly sensible questions,
a) 25 doctors answered them
b) three-quarters of the doctors got angry
c) the majority treated the patients as if they didn’t exist
d) a quarter answered their questions
10. What happened in the second experiment?
a) The doctors thought that a lot of real patients were pretending.
b) The doctors became less sure of themselves.
c) The doctors found all the pseudo-patients.
d) The doctors found none of the pseudo-patients.