On Being Sane in Insane Places

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In "On Being Sane in Insane Places" Rosenhan explains his experiment to determine whether the sane can be distinguished from the insane. After sane volunteers admitted themselves by faking psychotic auditory hallucinations, they returned to normal behavior, spent their time noting observations, and were discharged with a diagnosis of schizophrenia in remission. Although the staff did not detect them, the patients suspected their sanity. Doctors fail to detect sanity because they are inclined to call a healthy person sick than a sick person healthy due to cautiousness. In a second study, the staff was informed that a pseudopatient would be admitted in their hospital and asked to rate each patient as to the likelihood of them being one. Many patients of the hospitals regular intake were judged to be pseudopatients when none was present, illustrating failure to detect insanity. A psychiatric label colors others’ perceptions of him and behavior. There is an enormous overlap in behaviors of the sane and insane but in the context of a psychiatric hospital, everyday human experiences and behaviors were interpreted as pathological. For example, nursing records showed pseudopatients writing as an aspect of pathological behavior. Hospitalization is counter-therapeutic and dehumanizing. The staff ignored patients’ requests. The absence of eye and verbal contact reflect avoidance and depersonalization. The sources of depersonalization emerge from attitudes of fear and distrust held by all of us toward the mentally ill and hierarchical structure of the psychiatric hospital. Patients don’t spend much time in interpersonal contact with doctoral staff and this model inspires the rest of the staff. Depersonalization led to powerlessness, which was evident everywhere including restricted freedom of movement and minimal privacy of patients. Knowledge of mental illness is limited
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