Psychology: Essential Thinkers, Classic Theories, and How They Inform Your World - Andrea Bonior 2016

David Rosenhan
Social Psychology
The Canon

BORN 1929, Jersey City, New Jersey

DIED 2012, Palo Alto, California

Educated at Yeshiva College and Columbia University

BIG IDEA

David Rosenhan, with one provocative, controversial experiment—its results were published in the journal Science in 1973, under the title “On Being Sane in Insane Places”—pierced the bubble of prestige that had come to envelop the field of psychiatric care. He sent mentally healthy participants to 12 psychiatric institutions, where the participants reported to admitting staff that they had been hearing voices. The hospitals then diagnosed the participants—mostly with schizophrenia, one of the most serious psychiatric conditions—and admitted them for treatment. A striking aspect of Rosenhan’s experiment was its demonstration that when someone is given a psychiatric diagnosis—even, as in the case of the participants, when the diagnosis is false—it becomes a lens through which others see every facet of the person’s behavior, even behavior that is completely normal. Rosenhan challenged, in a major way, the validity and reliability of how psychiatric hospitals arrive at diagnoses, and he asked what hospital staff is really willing to see when looking at patients. He argued that the psychiatric setting itself can become an environment that promotes insanity rather than sanity. He showed that those who work in psychiatric institutions, from orderlies to head psychiatrists, are prone not only to label healthy people as sick but also to label sick people as healthy. Perhaps most important of all, he showed that once someone is labeled with a diagnosis, it tends to become what he called “sticky,” a defining declaration of insanity, even when the person shows no behavior that fits the diagnosis.

How, then, should we define abnormal behavior? If the difference between sanity and insanity can be so hard to quantify, what are the true markers of abnormality? In 1988, Rosenhan and Martin Seligman proposed seven parameters of abnormality; none, by itself, automatically means that a person’s behavior should or will be deemed abnormal, but the more the behavior conforms to these parameters, the more likely it is that the behavior is or will become abnormal:

”Suffering, of course, is clear—the person is in distress.

”Maladaptiveness means that something about the person’s behavior is getting in the way of his or her ability to meet goals or go through daily life.

”Vivid/unconventional behavior emphasizes how much the person’s behavior differs from that of others.

”Unpredictability/loss of control may include inappropriate or erratic behavior.

”Irrationality/incomprehensibility involves an element of behavior whose motivation defies clear explanation.

”Observer discomfort refers to the unease that those watching this behavior will feel.

”Violation of moral/ideal standards occurs when the behavior does not fall within the established values of society.

Of course, some of these seven parameters may be matters for subjective judgment, but they paint a picture of the axes that we should, and tend to, think along when we discuss abnormality. They also offer more nuanced explanations of abnormality than can be found in the DSM-5.

THEN WHAT?

The publication of David Rosenhan’s article “On Being Sane in Insane Places” shook up the field of psychiatry. It opened a discussion about the weaknesses of the medical model of treatment and about the potential biases of mental health care providers. It highlighted the dangers of overpathologizing and directly influenced various attempts at reform. Though Rosenhan’s marquee experiment is no doubt what made his name in the field, he also did groundbreaking work at the intersection of psychological practice and the law. For example, he used techniques from the field of experimental psychology to look at how well jurors followed court-ordered instructions to ignore inadmissible evidence.

WHAT ABOUT ME?

What comes to mind when you read the following words?

”Schizophrenic

”Bulimic

”Manic-depressive

”Alcoholic

Do you read them as adjectives? If so, to whom are they attached? Imagine the people who are described by these adjectives. Imagine them all sitting together at a table. Is there yelling? Agitation? Are they in group therapy together? Are they locked up in a hospital? Or—imagine this—could they be family members sitting together and laughing warmly as they enjoy Thanksgiving dinner?

Now imagine a professor who has overcome schizophrenia. Imagine an artist who has had bouts of bulimia. Imagine a scientist with a history of bipolar disorder. Imagine a retired banker who has triumphed over alcoholism. Now we get a little more nuance, don’t we? Maybe you see a man lecturing to an auditorium of rapt students, or a woman greeting guests at the opening of her sculpture exhibit, or a man doing card tricks for his grandchildren and saying, “No, thank you” when someone offers him a beer. Now these people are starting to look a little more human. But they’ve never not been human! Every single person in a therapy group or a psych ward or an AA meeting or at that Thanksgiving table has the same amount of humanity. Every person we meet and see is, by definition, a human being, but their humanity seems to wax and wane according to the labels we initially apply to them—and when we slap on the label of a mental health disorder, their humanity seems drastically diminished. We even turn adjectives—schizophrenic, bulimic, manic-depressive, alcoholic—into nouns, as if these nouns could actually encompass individual people themselves. Our language shows us that we’re often more interested in a disorder than in the person who suffers from it. But this is a flawed way of thinking. That’s why I teach my students, on the first day of class, that someone is a person with schizophrenia rather than a schizophrenic, and so on. When we put the person before the label, we can more easily remember his or her humanity, which hasn’t disappeared just because he or she is suffering from a psychiatric illness.