Labels for you and me.
By: Stephen Ames
The importance of labels was memorably expressed by R.D.Laing. He claimed that
if someone labeled a scientist said "All men are machines", he might
receive a Nobel prize. In contrast, if someone labeled a schizophrenic said
"I am a machine", he would promptly be locked away.
An attempt to evaluate the relative merits of these two diametrically opposed positions, was made by David Rosenhan of Stanford University. David Rosenhan was extremely interested in the various approaches that have been adopted towards the treatment of psychiatric disorders. He wondered, is it really as simple to distinguish between normality and abnormality as is implied by the medical model?
Finally he came up with a way of trying to determine how well psychiatrist are able to distinguish between the normal and the abnormal, or between the sane and insane. What would happen if a number of entirely sane people attempted to gain admission to a mental hospital by pretending to have one of the symptoms of insanity? Would they be classified insane ? If they were admitted, would the staff realize that a mistake had been made?
The answers to these and other questions were obtained in a study in which eight
normal people, five men and three women, attempted to gain admission to twelve
different psychiatric hospitals. The twelve psychiatric hospitals were located
in five different states on the East and West coasts.
Each of the eight participants phoned the hospital asking for an appointment.
Upon arrival at the admissions office, each of them complained of hearing voices
(these voices were often unclear, but appeared to be saying 'empty', 'hollow',
and 'thud'. All were judged to be insane, and all were admitted to the hospital,
on the basis of their symptom. One was diagnosed as manic-depressive psychosis,
the others as schizophrenic. But as soon as they had been admitted the
participants stopped simulating signs of abnormality, although several had a
brief period of nervousness and anxiety because they felt they would immediately
be exposed as frauds.
While in the hospital, the participants indicated that they felt well and were no longer troubled by 'voices'. In general, they behaved in a friendly and cooperative way. The only strange activity they engaged in was they spent time writing down their observations about the ward they were in. To begin with, these notes were written in secret, but it became clear that the staff did not notice, so the note-taking was done quite openly. This, in my humble opinion, was accomplished because most people who work on a psychiatric ward (This is from personal experience) are some of the lowest functioning people in society. Their main concern is control of your thoughts and emotions. They seem to enjoy overpowering you to the point of the destruction of your mental faculties. What they can not accomplish with torture and punishment, they accomplish through pharmaceuticals. If you resist the taking of the pharmaceuticals, you will be held down and be given them by either injection or enema.
The structure of the various hospitals was such that those of the greatest professional status had the least to do with their patients. The average daily contact of the participants was about 6 minutes. The actual length of hospitalization ranged from 7 to 52 days.
The fact that all the participants were released within a few weeks would make
you think that the psychiatric staff discovered that they had been sane all the
time, but no. All of the participants were discharged with a diagnosis of
'schizophrenia in remission.'
Quite a number of the real patients did become suspicious about the
participants. The first three participants were placed in wards with a total of
118 patients, 35 of the patients voiced their doubts that the participants were
mentally ill. They said things like 'You're a journalist, or a professor. You're
checking up on the hospital.'
These findings suggest that the distinction between the sane and insane is so
blurred that psychiatrists constantly diagnose the sane for the insane. It is
ironic that over 30 percent of the real patients knew that the participants were
sane. As a matter of fact the participants, after insisting that they were ill
to the real bona-fide patients, the real patients still didn't buy it and
insisted that the participants were sane.
Rosenhan wondered whether he could show the opposite effect, the insane being
sane. He chose as his testing ground a research and teaching hospital. The staff
there had heard about the previous experiment and informed Rosenhan that they
would not be fooled.
The first thing Rosenhan did was inform the hospital staff at this hospital that he was going to send in one or more pseudo-patients and have them attempt to gain admission into the psychiatric ward during the following three months. Each member of the staff was asked to observe all patients who presented themselves for admission or in the ward and say whether they thought they were his pseudo-patients or genuine patients. Judgments were made on a total of 193 patients admitted for psychiatric treatment. Forty-one genuine patients were judged to be his pseudo-patients by at least one member of the staff. Nineteen patients were suspected of being frauds by one of the psychiatrists and another member of the staff. But the fact is, none of Rosenhan's pseudo-patients sought admittance during this time. The people that were judged to be impostors were in fact real patients. The staff did not know the difference. This proves that mental hospital staff do know that they are admitting people, diagnosing them mentally ill, prescribing them dangerous pharmaceuticals, even forcing them to ingest the pharmaceuticals when they know quite well that the people are sane. Rosenhan's conclusion was: 'It's clear that we cannot distinguish the sane from the insane in psychiatric hospitals'.
One of the other points made by Rosenhan concerned the degrading conditions experienced by his pseudo-patients during their stays in the Psychiatric Wards. Rosenhan himself saw a patient beaten for walking up to one of the staff members and saying 'I like you'. On numerous occasions, when the pseudo-patients approached staff members with polite requests for information, the staff simply ignored the request over 80 percent of the time and did not answer. When a question was presented to a psychiatrist it went unanswered and ignored over 70 percent of the time. That is how people are treated in the psychiatric wards at the hospitals that I have been admitted to also. Then if you ask more than once you are then threatened.
Now think about this. How many people receive chemotherapy for cancer when the fact is they don't have cancer at all. What about heart disease ? How many people are prescribed dangerous pharmaceuticals for heart disease that do not have heart disease. Last year over 170,000 people's deaths were caused by prescription drugs. Yet the American people line up for them. About 3,500 deaths were caused by illicit drugs such as crack, meth, heroin etc and zero deaths from marijuana. Yet you will go to prison if you are caught possessing one of these drugs and you will go to prison for a very long time if you are caught selling one of these drugs. The bottom line is that the drug dealer on the corner is responsible for far less deaths than medical doctors. The difference is that the drug dealer on the corner does not have a license to KILL like the M.D.!
These are prime examples of the Cognitive Dissonance of the common American mind.
THE END