Category: Geek stuff

One interesting bit of research described in Sam Harris’ The Moral Landscape concerns the ability of psychiatric hospitals to distinguish the sane from the insane:

Of course, there are many other other ways in which we can be misled by context. Few studies illustrate this more powerfully than one conducted by the psychologist David L. Rosenhan, in which he and seven confederates had themselves committed to psychiatric hospitals in five different states in order to determine whether mental health professionals could detect the presence of the sane among the mentally ill. In order to get committed, each researcher complained of hearing a voice repeating the words “empty,” “hollow,” and “thud.” Beyond that, each behaved perfectly normally. Upon winning admission to the psychiatric ward, the pseudopatients stopped complaining of their symptoms and immediately sought to convince the doctors, nurses, and staff that they felt fine and were fit to be released. This proved surprisingly difficult. While these genuinely sane patients wanted to leave the hospital, repeatedly declared that they experienced no symptoms, and became “paragons of cooperation,” their average length of hospitalization was nineteen days (ranging from seven to fifty-two days), during which they were bombarded with an astounding range of powerful drugs (which they discreetly deposited in the toilet). None were pronounced healthy. Each was ultimately discharged with a diagnosis of schizophrenia “in remission” (with the exception of one who received a diagnosis of bipolar disorder). Interestingly, while the doctors, nurses, and staff were apparently blind to the presence of normal people on the ward, actual mental patients frequently remarked on the obvious sanity of the researchers, saying things like “You’re not crazy. You’re a journalist.”

In a brilliant response to the skeptics at one hospital who had heard of this research before it was published, Rosenhan announced that he would send a few confederates their way and challenged them to spot the coming pseudopatients. The hospital kept vigil, while Rosenhan, in fact, sent no one. This did not stop the hospital from “detecting” a steady stream of psedopatients. Over a period of a few months fully 10 percent of their new patients were deemed to be shamming by both a psychiatrist and a member of the staff. While we have all grown familiar with phenomena of this sort, it is startling to see the principle so clearly demonstrated: expectation can be, if not everything, almost everything. Rosenhan concluded his paper with this damning summary: “It is clear that we cannot distinguish the sane from the insane in psychiatric hospitals.”

Harris, Sam. The Moral Landscape. p.141-2 (hardcover)

I believe this is the research being referenced: Rosenhan, D.L. “On Being Sane in Insane Places.” Santa Clara Lawyer 379 (1972-1973).

This doesn’t seem like the most scientific or ethical research, but it is certainly interesting.