MSL READING FOR FINAL-#19- CRIME AND DEVIANCE - Summarized and easy to understand
5 pages103 viewsWinter 2011
ProfessorMalcolm Mac Kinnon
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Chapter 19- MSL
ON BEING SANE IN INSANE PLACES
DAVID L. ROSENHAN
Deviance is the recognized violation of social norms; whether a person is labeled deviant depends on how
others perceive, define, and respond to that person’s behavior.
Rosenhan explores the social deviance of mental illness and the consequences of labeling people “sane”
Our notions of normality and abnormality may not be quite as accurate as people believe they are
There is a great deal of conflicting data on the reliability, utility and meaning of such terms as
sanity, insanity, mental illness, and schizophrenia.
Benedict (1934) suggested that normality and abnormality are not universal; what is viewed as
normal in one culture may be seen as quite abnormal in another
Normality and abnormality, sanity and insanity, and the diagnoses that flow from them may be
less practical than many believe them to be (questioning normality/abnormality does not question
the fact that some behaviors are deviant or odd; ex. murder, hallucinations, nor does it deny the
existence of psychological suffering)
To distinguish the sane from the insane (along with distinguishing degrees of insanity): Do the
prominent characteristics that lead to diagnoses reside in the patients themselves or in the
environments and contexts in which observers find them? (dispositional vs. situational)
From Bleuler, to Kretchmer, through the formulation of the revised DSM (Diagnostic and
Statistical Manual) of the APAbelief has been strong that patients present symptoms and those
symptoms can be categorized and implicitly, the sane are distinguishable from the insane
This belief has been questioned, psychiatric diagnoses are in the minds of the observers and are
not valid reviews of characteristics displayed by the observed
Questioning the modes of psychiatric diagnosis:
Getting normal people, persons who have never suffered symptoms of serious psychiatric
disorders (pseudopatients) admitted to psychiatric hospitals and determining whether they were
discovered to be sane and if so, how.
If the sanity of such pseudopatients were always discovered, there would be prima facie evidence
(obvious evidence) that a sane person can be distinguished from the insane context where he/she
If the sanity of such pseudopatients were never discovered, serious difficulties would arise for
those who support traditional modes of psychiatric diagnosis
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Given that the pseudopatient was behaving as sanely as he had been outside the hospital, that it
had never previously been suggested that he belonged in a psych. Hospital & the hospital staff
was not incompetent: such an unlikely outcome would support the view that psychiatric diagnosis
tells little about the patient but much more about the environment in which the observer finds
Eight sane people gained secret admission to twelve different hospitals. Their diagnostic experiences
contain data of the first part of this article, the remainder devoted to their descriptions of their
experiences inside the institution.
Very few people know what the experience is like (even having worked
Pseudopatients and Their Settings
Eight pseudopatients were varied group:
-One was a psychology graduate student in his 20s, remaining 7 were older and “established”
-Among them were 3 psychologists, a pediatrician, a psychiatrist, a painter, and a housewife
Three women, five men
-All employed aliases, those in the mental health professions alleged an alternative occupation in
order to avoid special attention
-Rosenhan was the first pseudopatient whose identity was allegedly only known to the hospital
administrator and chief psychologist
The hospital settings were similarly varied, the 12 hospitals were located in 5 different states on
the East and West coasts; some were old and shabby, others were new, some research oriented,
others not, some had good staff-patient ratios, others were understaffed; only one was a private
hospital. All of the others were supported by state/federal funds or in one instance, by university
After calling the hospitals for an appointment, the pseudopatient arrived at the admissions office
complaining that he had been hearing voices. When asked what the voices were saying, the
pseudopatient replied, though often unclear, they said “empty”, “hollow”; were unfamiliar and the
same sex as the pseudopatient.
Why? These symptoms were chosen because of their similarity to existential symptoms it
was as if the pseudopatient was saying “My life is empty and hollow”. Such symptoms arise from
the perceived meaningless of one’s life. There is also the absence of a single report of existential
psychoses in literature.
Other than having a fake name and occupation, there were no further alterations (to history, family
or circumstances). Everything about the pseudopatients life was described normally as it had been
or is outside the hospital; none of their stories (ex. of relationships with others) were seriously
pathological in any way.
Simulations of any symptom of abnormality were ceased upon admission (although in some cases
there was a brief period where the pseudopatient felt nervous and anxious because they were
nervous as to how easily they were admitted and what would happen to them, along with fear that
they would be exposed as fraudssuch feelings of fear and anxiety quickly subsided and the
pseudopatient went back to normal)
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