If you are admitted to a mental hospital, among many mental patients, how can you prove to the doctor that you are not sick?
Some people will say that I am a normal person, and I am definitely different from a mentally ill person who behaves like crazy. Doctors and nurses are not stupid, so how could they not tell the difference?
I believe that most people will have this idea. There was once a joke that a well-known reporter went to a local mental hospital for an interview.
During the interview, the reporter asked the dean: "How do you judge whether the patient has recovered?"
The dean smiled and said: "It's very simple. We will fill a large bathtub with water and put it next to it. Put a spoon and a basin, and ask them to empty the water in the bathtub as quickly as possible."
reporter suddenly understood and said proudly.
"I see, normal people will use a basin to scoop water out instead of a spoon, right!"
"No, normal people will pull out the cork under the bathtub." dean said.
Although it is just a joke, it reflects a real problem, that is, can doctors really distinguish between mental patients and normal people?
As early as 49 years ago, David Rosenhan conducted a similar experiment, and the results of the experiment are believed to be beyond many people's expectations.
01 Normal people in mental hospitals
David Rosenhan was born in Jersey City, New Jersey, in the United States in 1929. After receiving a doctorate from Yeshiva University , he taught at Swarthmore College in the United States.
In the psychology class, Rosenhan was talking, but the students in the audience were confused.
Some students complained that his class was too abstract, but instead of getting angry, Rosenhan was inspired.
Therefore, Rosenhan decided to go to the mental hospital to experience the life of a mental patient in person. After spending nine difficult days in the dark hospital, Rosenhan couldn't hold on any longer.
However, these nine days were not without success. During these few days, Rosenhan had a profound understanding of the darkness of patients' lives. Looking at many unprofessional nurses and doctors, Rosenhan suddenly had something in his mind. An idea.
Can these so-called doctors really distinguish between mentally ill people and normal people?
When this bold idea was formed in his mind, in 1973, a plan was born.
First, Rosenhan found eight normal people from society who volunteered to participate in the experiment. They came from all walks of life.
Among them are 3 psychologists, 1 graduate student, 1 psychiatrist, 1 pediatrician, 1 painter and 1 housewife.
Several people were mentally healthy and had no history of genetic mental illness. Before the experiment began, they were asked not to take a shower or cut their hair or nails for several days to make themselves look as haggard as possible.
Finally, with the help of lawyers, several people went to different mental hospitals in the United States.
Some are large public hospitals and some are luxurious private hospitals, and their "symptoms" are the same. Eight people told the doctor that they often hear "buzzing" or "rumbling" sounds.
Because of the technical conditions at the time, it was impossible to tell whether what the patients said was true or false, and several people were imprisoned in mental hospitals because of so-called auditory hallucinations.
The hospital finally came to a surprising conclusion after examining several people.
That is, among the eight people, seven of them were diagnosed with schizophrenia , while the other person was considered mania .
The reason why he was diagnosed with mania was even more bizarre. After being admitted to the hospital, the doctor asked about the man's family and relationship status.
The man said that he and his wife have a very good relationship. They rarely quarrel. The child is relatively sensible and occasionally naughty, so he will teach him a lesson.
In the end, he was diagnosed as manic, with a tendency to hurt others and a strong desire to control.
After several people successfully entered the mental hospital, the real experiment was about to begin.
In the hospital, several people behaved like normal people. They got up, ate, and walked as usual every day. Everything was no different from how they behaved at home.
So among the many mentally ill patients with weird behaviors, will a few normal ones be discovered by doctors at a glance?
And the results were once again beyond everyone's expectations . The experimenter's normal behavior did not attract the attention of the doctors at all.
Sometimes they walk in the hallways, which doctors interpret as a sign of agitation.
One of the experimenters is left-handed and always uses his right hand when eating. This will also be considered by doctors as a sign of mental illness.
Since several experimenters have to record their daily routine every day, they all carry a small notebook with them.
Once, when an experimenter was concentrating on writing experimental records, a doctor suddenly appeared next to him.
The experimenter was startled. Just when he thought the matter was exposed, he didn't expect that the doctor didn't even read what he wrote. He just opened the medical record lightly. wrote "nervous, scribbling" in the symptom column. ".
If you confess to the doctor that you are not sick and everything is fake, then they will think you are talking nonsense or delusional.
Once you get emotional and try to explain that you are a normal person, you will be considered violent and a shot of tranquilizer will be shot in your arm.
02 Rosenhan Experiment
Such an unscientific diagnostic method is ridiculous and terrifying. It can't help but remind people of the plot in the movie "One Flew Over the Cuckoo's Nest".
The male protagonist Mike in the movie pretended to be mentally ill and was imprisoned in order to avoid prison punishment. Under the management of the arbitrary head nurse, all the actions of the patients must strictly follow her instructions.
Such a depressing life naturally aroused Mike's dissatisfaction, so he would secretly take the patients to play ball, watch games, and hold entertainment activities.
Gradually, smiles appeared on the faces of the patients, but this angered the head nurse. She believed that Mike's arrival had endangered her status.
Once, a patient committed suicide because of the cold-blooded head nurse. The furious Mike strangled the head nurse's neck. He wanted to end the devil's life, but the security guard who arrived later knocked him down with a stick.
When he woke up, he was already tied to the hospital bed. Although he repeatedly emphasized that he was not mentally ill and was just pretending, it was too late.
Normal Mike eventually had a prefrontal lobotomy surgery because of his serious tendency to hurt others.
So what is prefrontal lobotomy surgery?
You can think back on what is the cruelest surgery you have ever heard of.
In Czech , sex offenders will be chemically castrated to reduce the prisoner's desire. Many plastic surgery hospitals will shave off patients' bones to shape them, and even remove their ribs to create a slim figure.
But compared with the following frontal lobotomy surgery, it is still too childish.
At the beginning of the operation, the patient will be tightly tied, and the doctor will insert a cold awl into the patient's eye socket, and then tap it little by little with a hammer until it penetrates the patient's brain. At this time, he only needs to gently With one turn, the sharp awl will shatter part of the patient's brain. From then on, the person will become stupid and lose the ability to think.
In the 19th century, this operation was often used by doctors as a means to treat mental patients. Patients with epilepsy, anxiety, and mania would all become sheep for slaughter as long as they underwent prefrontal lobe removal.
The most ironic thing is that in 1945, Portuguese doctor Antonio Moniz won the Nobel Prize in Physiology or Medicine for this.
At that time, if the children did not do their homework or were naughty, then parents would take them to undergo prefrontal lobotomy surgery , and the most popular surgery was on those with mental illness. At the end of the movie
, Mike, who had undergone a prefrontal lobe resection, was completely reduced to a walking zombie that could only drool, and other people affected by him also decided to start a new life.
Just like the description in the movie, in real life, doctors in major mental hospitals failed to identify the true identities of several people. In the end, with the help of lawyers, they were successfully discharged.
But it was not because their identities were discovered, but because several people announced that the symptoms of auditory hallucinations disappeared after entering the hospital, and they were allowed to be discharged after their "conditions improved".
Therefore, even if they are qualified for discharge, they are still considered to be relatively stable mental patients. The results of the
experiment had a big impact on Rosenhan.
In 1973, after sorting out all the information, Rosenhan published the results of the experiment in the magazine "Science".
The results were as expected, and the experimental results caused an uproar in society as soon as they were announced.
03 Great changes in the medical field
In the article, Rosenhan described in detail the entire experiment and the attitude of the doctors in the hospital.
He said that the communication time between doctors and patients does not exceed 8 minutes every day. Many times, the doctor will leave before the patient has finished speaking. They are more like completing their daily tasks rather than diagnosing the disease. Faced with the initiative of the experimenter, Even if you say hello, they will ignore you and try to reduce contact with patients as much as possible.
Once, a female nurse unbuttoned her nurse's uniform and straightened her bra in front of a male patient.
She wasn't trying to seduce anyone, but in the eyes of the nurse, she didn't regard these mental patients as normal people at all.
The most ironic thing is that although the doctors did not discover the true identity of the experimenter, other mental patients were discovered by them.
Once, a mental patient approached the experimenter and said to him: "You must be a reporter, or you are here to experience life. In short, you do not belong here."
This is not an isolated case. Many mental patients seem to feel this. In order to calm the patient's emotions, the doctor would prescribe some sedative drugs to the patient every day.
As normal people, the experimenters naturally would not take it, so every time they would hide the medicine under their tongues, and then flush it into the toilet when the doctor was not paying attention.
But what is ridiculous is that they are not the only ones who secretly throw away medicines. Many patients secretly throw away medicines in the toilet, thinking that they are also normal people hiding in mental hospitals.
Because in 1972, during the Vietnam War , in order to avoid being drafted into the army, a large number of American young people would pretend to be mentally ill to avoid being drafted.
A bunch of normal people are hiding in a mental hospital, but the hospital is not aware of it at all. This is ridiculous and absurd.
Therefore, Rosenhan proposed the "labeling effect" in his article. He believed that a mental hospital is a special environment. Once you enter it, you will be labeled as "mentally ill" regardless of whether you are a normal person or not.
Under this label, no matter how normal your behavior is, you will be treated differently and identified as a mental patient.
Once a person is designated abnormal, all of his other behaviors and characteristics are colored by that label.
At the same time, Rosenhan also believes that as doctors, they are more inclined to say that a healthy person is sick rather than that a sick person is healthy.
He believes that doctors should use more neutral terms to describe the behavior of patients, rather than simply assuming that they are sick with strong emotional overtones.
In the ten years since this shocking article was published, dozens of mental illness-related institutions in the United States have closed down, and the number of mentally ill patients in the entire United States has also dropped by nearly 50%.
Behind the experiment, a more terrifying and dark issue was realized, that is about the mental identification of criminals.
In the United States, juvenile delinquency is very common, and because the law is generally not strict in punishing minors, many juvenile offenders are identified as suffering from depression , split personality and other mental illnesses, and thus obtain A lighter punishment.
Imagine that if medical institutions cannot correctly distinguish the difference between mental patients and normal people, then a heinous criminal can disguise himself as a mental patient and escape punishment with a false identification certificate. How terrible is this? matter.
And the courts in the United States are also aware of this matter.
To this end, the American Psychiatric Association has rewritten the diagnostic manual, and they have established new identification standards to make up for the shortcomings of previous studies.
At the same time, American courts have also weakened the judgment of psychiatrists to avoid prisoners using mental illness to avoid punishment.
04 Ridiculous secondary experiment
After his article was published, many psychologists expressed strong interest in this experiment. They all came forward to support Rosenhan's conclusion and claimed that they had conducted similar experiments.
Although Rosenhan's article caused a series of shocks in the American medical community, many people still stood up to oppose his research.
Susanna, a patient who was once misdiagnosed as a mental patient, questioned Rosenhan's related experiments in all aspects in her best-selling book "The Great Pretender: The Undercover Mission That Changed Our Understanding of Madness".
According to her investigation, the experimental subjects were not eight people, but nine.
Although Rosenhan publicized that they would no longer admit to having auditory hallucinations and other symptoms after entering the hospital, Harry, the ninth man, fabricated his symptoms in the hospital, which led to the doctor's misjudgment. Therefore he was omitted from Rosenhann's data.
Susanna believes that it is unreasonable for Rosenhan to only choose evidence that is strong for his conclusion to support his argument.
Although Suzanne's book is a best-seller, as a journalist, her remarks cannot overturn Rosenhan's experimental conclusions.
Those who are most opposed to the conclusions of Rosenhan's experiment are of course those hospitals that were once his experimental subjects.
After the article was published, the reputation of several hospitals plummeted. Patients were taken away by their families one after another, and hospitals that were originally overcrowded suddenly became empty.
The hospital believed that Rosenhan had deceived the doctors. They asked Rosenhan to send experimenters again within three months. This time they would be able to distinguish normal people from patients, and Rosenhan also readily accepted it.
Therefore, under the attention of all walks of life, has started a new experiment with . This is a battle for the dignity of traditional American psychiatric medicine. All hospitals are gearing up and must fight this turnaround.
In the following time, they used all the knowledge they had learned to carefully distinguish the strangeness of the new patients.
Even the smallest clues were discovered by them keenly.
Three months later, several hospitals issued a joint statement. Among the 193 newly admitted patients in the past three months, 41 were normal people pretending to be normal people, and 42 were suspected patients.
When they confidently found Rosenhan to confront him, Rosenhan just said a word.
"I didn't send anyone there."
