What does the movie Shrek have to do with labeling, the DSM-V and the self-fulfilling prophecy? In this episode I take a close look at the well-known Rosenhan study. This was the study in which “pseudopatients” pretend to hear voices and on the basis of this they get admitted to psychiatric centers. Then they were told to act “normally”. It took an average of 19 days for these “pseudopatients” to be discharged from the hospital and even then they were diagnosed as “schizophrenia in remission“.
Does this study show that psychiatric diagnoses are not only useless but also possibly harmful? Or do we find what we found back in episode 47 on Little Albert, and what we found in episode 36 on Kitty Genovese – what we thought we knew is largely wrong.
“[The Rosenhan study is]…a prime example of extremely compelling writing in conjunction with remarkably sloppy reasoning.” – Scott Lilienfeld
…a careful examination of this study’s methods, results, and conclusions leads me to a diagnosis of “logic, in remission.” – Robert Spitzer
Resources on the Rosenhan Study
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- Rosenhan, D. (1973). On Being Sane in Insane Places. Science, 179, (70), 250-258.
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- Diagnoses and the Behaviors They Denote: A Critical Evaluation of the Labeling Theory of Mental Illness John Ruscio, Department of Psychology, Elizabethtown College.
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- Spitzer, L. (1975). On Pseudoscience in Science, Logic in Remission, and Psychiatric Diagnosis: A Critique of Rosenhan’s “On Being Sane
in Insane Places”. Journal of Abnormal Psychology, 84 (5) 442-452.
- Spitzer, L. (1975). On Pseudoscience in Science, Logic in Remission, and Psychiatric Diagnosis: A Critique of Rosenhan’s “On Being Sane
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- Weiner, B. (1975). “On Being Sane in Insane Places”: A Process (Attributional)
Analysis and Critique Journal of Abnormal Psychology, 1975, 84(5), 433-441
- Weiner, B. (1975). “On Being Sane in Insane Places”: A Process (Attributional)
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- On Being Sane in Insane Places summarized in Wikipedia
Popular Press Articles on the Revision to the DSM
DSM-V Resources
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- DSM Revision Activities from the American Psychiatric Association
The Abnormal Psychology of Creativity - Zen Linked
April 22, 2010[…] Psychologist Michael Britt includes some excerpts like these from “Shrek” in his podcast DSM-V and On Being Sane – Are Psychiatric Labels Really Harmful? […]
Living in an Asylum | The Psych Files
April 22, 2010[…] DSM-V and On Being Sane – Are Psychiatric Labels Really Harmful? […]
Rich
April 22, 2010I would disagree with you of your thoughts about the label as society put labels on people through the only field that can make a person a medical deviant. The study wasn’t flawed in a since that eight sane people spent 152 days in an institution specifically designed to detect the insane. That is the flaw in your argument. Over 50 medical personnel couldn’t see these people as sane and still gave them a label of remission because they couldn’t be wrong in the first diagnosis. Sad and shameful.
Esther
April 22, 2010It would have been helpful to know more of the information on which the hospitals admitted these patients. The issue with labels is interesting. I guess we want them when they benefit us or bring relief but don’t want them if they are perceived as negative. Only in the mental health profession is this such a problem. For so long I couldn’t accept I was depressed because I felt people had a negative view of this and that I needed medication for this. Medically, I want to find a diagnosis, a label for my daughter who has an undiagnosed disability. For me, us, it would be a sigh of relief to know somewhat what to expect in the future.
AJ Jack
April 22, 2010I worked as an IT manager in a health service and my office was on the campus of a psychiatric hospital. When I arrived I was told “If you want to pick out the nurses from the patients, the nurses are the ones wearing shoes.”
Not the most sympathetic of approaches to mental health.
Michael
April 22, 2010Thanks Caridad! Appreciate the encouragement.
Caridad
April 22, 2010Very good episode. I really enjoyed listening to it. Keep up the good work!!
Michael
April 22, 2010Derek: All in the Mind is one of my favorite shows. Thanks for the link. Listening now…
Derek Weber
April 22, 2010This was a really interesting episode. I hadn’t heard of the study but the concept is very familiar.
Although it’s a bit of a tangent, it reminded me of a recent episode of Radio National’s (Australian Broadcasting Commission) All in the Mind about the psyche of whistleblowers (and the effects on it of blowing the whistle, as it were), especially when a common corporate tactic is to send the whistleblower to a psychiatrist. Very interesting listening: http://www.abc.net.au/rn/allinthemind/stories/2010/2901944.htm
Michael
April 22, 2010Zul: thanks for the comment and glad you’re enjoying the podcast!
Zul Strait
April 22, 2010Hi Michael I’m a listener from Singapore…I study Biological science in a local university but have always be interested in Psychology….I listen to your podcasts on my trip to school everyday to learn something on Psychology…Your podcasts have always been entertaining while being educational at the same time…Keep up the good work!!!
Matt
April 22, 2010Hi Michael,
There are several psychology lecturers at our College that would like to use your podcasts on our College network (VLE). Is it okay for us to download a few of your podcasts and make them available to students at the College. We’re aiming to make our own podcasts, but lecturers have found your’s to be very useful in the past.
Kind regards,
Matt
Douglas Eby
April 22, 2010Thanks for another stimulating podcast. As you point out, mental health professionals with training and understanding can and do provide real help. For example, I have experienced benefit in the past from diagnosis and treatment for depression. But there can be limits or gaps in expertise for some professionals, who can misdiagnose or mislabel or simply misunderstand exceptionally creative or gifted minds.
In his paper The Abnormal Psychology of Creativity, Steven James Bartlett quotes psychiatrist Kay Redfield Jamison: ‘There is a great deal of evidence to suggest that, compared to “normal†individuals, artists, writers, and creative people in general, are both psychologically “sickerâ€â€”that is, they score higher on a wide variety of measures of psychopathology—and psychologically healthier (for example, they show quite elevated scores on measures of self-confidence and ego strength).’
No doubt many less-informed or experienced mental health workers can misconstrue these seemingly conflicting elements of pathology and health, or the unusual psychological aspects of high ability people.
James T. Webb, Ph.D. thinks “Many gifted and talented children (and adults) are being mis-diagnosed by psychologists, psychiatrists, pediatricians, and other health care professionals.”
Creativity and madness: The Abnormal Psychology of Creativity
April 22, 2010[…] Psychologist Michael Britt includes some excerpts like these from “Shrek” in his podcast DSM-V and On Being Sane – Are Psychiatric Labels Really Harmful? […]
Michael
April 22, 2010Terry: the audio player I’m using for this episode is a little different from the others, but you should still be able to drag the little diamond back and forth just like other episodes.
terry
April 22, 2010It would have been helpful to have mentioned how long this episode is, and to have the ability to stop, repeat and forward the episode, like in previous psych files.