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Sociology (1,053)
SOCB51H3 (15)
Joe Hermer (15)

On Being Sane and Insane Places.docx

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University of Toronto Scarborough
Joe Hermer

On Being Sane and Insane Places - D.L. Rosenhan  If sanity and insanity exist how shall we know them?  There are a great deal of conflicting data on the reliability, utility, and meaning of such terms as sanity insanity mental illness and schizophrenia.  What may be viewed as normal in one culture may not be normal in another so the notions of normality and abnormality are not as accurate o Some behaviors are deviant or odd. Murders are deviant and so are hallucinations, and there is a personal anguish that is associated with mental illness. Anxiety and depression exist and psychological suffering that exists o However sanity and insanity; normality and abnormality and the diagnoses that flow from them may be less substantial  Do the salient characteristics that lead to diagnoses reside in the patients themselves or in the environments and contexts in which observer find them? o From the DSM the belief has been strong that patients present symptoms and those symptoms can be categorized and the sane can be distinguished from the insane o Psychological categorization of mental illnesses is useless at best and downright harmful, misleading, and pejorative at worst.  Psychiatric diagnoses in this view are in the minds of the observers and are not valid summaries of characteristics displayed by the observed  Gains can be made in deciding which of these is more accurate by getting normal people (that is people who do not have and have never suffered, symptoms of serious psychiatric disorders) admitted to hospitals and then determining whether they were discovered to be sane and if so how. o Normality (and presumably abnormality) is distinct enough that it can be recognized wherever it occurs for it is carried within a person o If on the other hand the sanity of the pseudopatients were not discovered serious difficulties would arise for early psychiatric diagnosis  Eight sane people gained secret admission to 12 different hospitals o Too few psychiatrist and psychologists even those who have worked in such hospitals know what the experience is like and rarely talk about it with former patients because the distrust information coming from the insane. o Those in psychiatric hospitals are likely to have adapted so thoroughly to the settings that they are insensitive to the impact of that experience o The eight pseudopatients were a varied group. One was a psychology graduate student in his twenties. The remaining seven were older and established. Among them were three psychologists a pediatrician, a psychiatrist, a painter, and a housewife. Three pseudopatients were women five were men. All of them employed pseudonyms lest their alleged diagnoses embarrass them later o Asked what the voices said he replied that they were often unclear but as far as he could tell they said empty hollow and thud. o Such symptoms are alleged to arise from painful concerns about the perceived meaninglessness of one’s life. It is as if the hallucinating person were saying ‘My life is empty and hollow’. The choice of these symptoms was also determined by the absence of a single report of existential psychoses o No future alterations of person, history, or circumstances were made other than alleging symptoms, employment and name.  Relationships with parents and siblings with spouse and children with people at work and in school consistent with the aforementioned exceptions were described  Frustrations and upsets were described along with joys and satisfactions  Brief period of nervousness and anxiety since admission was easy but apart from that spoke normally and behaved normally  The pseudopatients very much as a true psychiatric patient entered a hospital with no foreknowledge of when he would be discharged  Despite their public show of sanity the pseudopatients were never detected  Could be due to the quality of hospitals  Daily visitors could detect no serious behavioral consequences nor indeed could other patients  Common for the patients to detect the pseudopatients sanity  Failure to detect sanity during the course of hospitalization may be due to the fact that physicians operate with a strong bias toward what statisticians call the type 2 error.’ This
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