Friday, 18 March 2011

Psychology Friday: One Flew Over the Cuckoo's Nest

The idea that someone perfectly sane could be admitted to a psychiatric hospital is nothing new. Neither is the belief that there are some people out there who ought to be in hospital, but aren't. It's the stuff of criminal psychiatric profiling, for a start. It's also the stuff of hard-nosed academic research, as well as this wonderful work of fiction by Ken Kesey and an Oscar-winning film starring Jack Nicholson.

But first, the research. In 1973 David Rosenhan and seven other volunteers decided to try to get themselves admitted to a psychiatric hospital. They had to 'phone the ward reporting having heard a 'thud' in their heads, but this was the only lie they were to tell. All eight were admitted; seven were diagnosed with schizophrenia and one with bi-polar disorder. In spite of behaving perfectly rationally, they were all held for between 7 and 52 days and only eventually discharged on the grounds that their 'disease' (they hadn't got one, remember?) was in remission. In other words, the label stuck.

Needless to say, the hospitals were rather annoyed. So Rosenhan challenged them to spot some more 'pseudo patients' (all perfectly sane) and tell him - over the course of the next three months - how many people they had seen that they considered sane. And the results? During the three month period almost 200 patients were admitted, of whom between 19 and 41 were considered to be actors. But Rosenhan had sent no-one. In other words, all the patients the medical establishment suspected were fakes were real-life potential sufferers of psychiatric illness.

All of which gives a whole new meaning to the cliché that the lunatics have taken over the asylum.


  1. I guess sanity is a spectrum - and we're all on it somewhere, some near the middle, some frighteningly close to the edges...

  2. Even more to the point, Steve, is the fact that several eminent psychiatrists have argued that 'madness' is in fact a perfectly sane response to the crazy world we live in...

  3. Totally agree with Steve - who isn't crazy?

  4. And I suppose the Catch-22, Polly, is if you claim not to be...

  5. That's pretty scary and leaves one with little faith in the profession.

    Or it highlights how clever the research was a) for identifying flaws; b) by exploiting them.

  6. Well, let's hope it's the latter, Sarah - and that lessons have been learned. But like any diagnosis based on behaviour rather than physical symptoms I suspect there'll always be mistakes.

  7. Over here in the states, they just wander the streets, occasionally getting incarcerated for petty crimes. Most asylums are closed. We really are living in a crazy world.


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