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While this is fascinating and I'm glad to have read it, it doesn't substantiate that this experiment set back psychiatry. The fact that the DSM-IV was prompted

While this is fascinating and I'm glad to have read it, it doesn't substantiate that this experiment set back psychiatry. The fact that the DSM-IV was prompted or encouraged by the experiment is suggested, but there's no argument for it. Even beyond that, the article doesn't even hint at an argument that the DSM-IV set back psychiatry (except offering the bare assertion that reductionism is false). Of course, the DSM is very controversial, and many people could fill in the argument, but this article doesn't do it.

peteretep 7y ago
This is standard fare for the source. The Spectator generally pick one of the authors' bugbears (usually Muslims, The Left, or Political Correctness Gone Mad), write a beautifully written and entertaining piece, all the time aggressively mixing and conflating fact and fiction with a slightly sneering tone. For example: https://outline.com/nMzA8N https://outline.com/nMzA8N
- hinkley 7y ago
  Makes the site name a bit on the nose, doesn't it?
taurath 7y ago
How many mental hospitals were closed in the 80s due to this?
- 77pt77 7y ago
  Not enough. This article is nothing but propaganda. These experts never explained why homosexuality was considered a mental illness and later that decision was reverted. Neither of those changes was ever justified. It's almost like those decisions are made with no objective criteria.
  - deleted 7y ago
    [deleted]
hsyqiwgx 7y ago
The DSM is controversial because it's only scientific until political groups take interest. The trans community lobbied and bothered academics over the DSM's definition for Trans people until the academics threw up their hands and decided their funding wasn't good enough to justify having a spine and so the definition in the DSM was changed with a minimum of real science to justify it. That's psychology as a field in a nutshell.
- ringzero 7y ago
  Ah, so you’d also agree homosexuality is a mental illness that “political groups” lobbied to change? Because, from the perspective of someone who isn’t a conspiracy theorist or bigot, it looks like the DSM updated their definition as more research and academic interest rendered the old definition outdated.
  - msla 7y ago
    There's an actual, interesting question here, away from the Culture War fighting, which we can have if we want it: How much of any academic field is due to the culture that field is immersed in, and how much is due to empirical evidence and people attempting to be unbiased? For example, there's the existence of Jesus Christ: Modern historians agree that there was a man named Joshua-son-of-Joseph who was a heretical rabbi in the First Century Middle East who got crucified by the local authorities. Why? Is it because the evidence for him is just that good, or is it because most scholars in Christian countries were Christian and, therefore, unapt to question their surrounding culture? With Jesus, it's because of the evidence, as it happens, but the question is there, and hooting it down does a disservice to larger questions all fields have to confront as they mature.
- throwawayjava 7y ago
  As society changes, what it means to be maladapted to that society also changes. It's amazing how many people will agree with that statement (because... duh) and then freak out when someone points out it's impossible to talk about the DSM without talking about dominant beliefs regarding "what society should be like". I.e., without talking about politics and labor economics. There are many topics covered by the DSM that are maladaptations to this society but a) would not have been maladaptations in previous soecieties, and b) might not be maladaptations in future societies. Is it even possible to talk about something like whether some particular aspect of human sexuality is a disorder using only "real science", and on a related note, what does "real science" mean here? E.g., there have certainly existed human societies with no strong taboo around human nakedness, and in those societies Exhibitionistic Disorder wouldn't even make any sense to talk about. Similarly, it'd hard to imagine ADD being anything other than a perfectly normal non-maladaptive variation in personality prior to industrialization. As a practicing scientist, I'm honestly not sure how "real science" is supposed to given an answer a question like 'is being transexual maladaptive?" It's just not a scientific question. There are lots of related scientific questions about human biology. But ultimately, it's a question about how those biological facts interact with social constructions. Can you tell me, concretely, what you mean by "real science" here?
s1artibartfast 7y ago
Yeah, I wish the article was more clear on why Rosenhan's article was important and what exactly is claimed in The Great Pretender. Re-reading the article, It seems to suggest that it undermined public trust in forced psychiatric treatment. I can only guess that the author believes this was for the worse and is the titular setback?
- smileypete 7y ago
  Late to this; but here's a Q&A with the author which may shed some light: https://www.c-span.org/video/?466007-1/qa-susannah-cahalan https://www.c-span.org/video/?466007-1/qa-susannah-cahalan
ttctciyf 7y ago
Interestingly, the article makes no mention of the followup experiment where it seems a hospital invited a repetition and then claimed to have found 40 or so fake patients during the agreed period. Only to be told that the experimenters had sent none. Or at least that's the version told in Adam Curtis' documentary The Trap (part 1)[1] which engages in Curtis's usual enthusiasm for fashioning a sweeping historical narrative out of somewhat sparse materials - in this case presenting the "Thud" experiment and its followup as a pivot point in the tale of how R. D. Laing's anti-psychiatry ironically led to the advent of the DSM IV era. However that may be, if Curtis' account of the followup is correct it seems harder to argue the diagnostic prowess of the psychiatrists was not open to question, regardless of the status of the original experiment. 1: In the section beginning here: https://youtu.be/y97Ywl7RtUw?t=2204 https://youtu.be/y97Ywl7RtUw?t=2204
- 77pt77 7y ago
  > Interestingly, the article makes no mention of the followup experiment where it seems a hospital invited a repetition and then claimed to have found 40 or so fake patients during the agreed period. The reason is simple. This article is pure propaganda along the lines of the book "The great pretender" by Susannah Cahalan. The experiment might have flaws, but this second part is conclusive and no critics ever address it. This is just another brick on the long propaganda road to a destination that is very worrisome.
  - warbaker 7y ago
    My default position on the follow-up is likewise skepticism. It seems like the filters at the time were so low that it is likely the follow-up is just a better constructed lie.
    - 77pt77 7y ago
      What about the argument, used at the time, that in order for someone to participate in an experiment like that they had to be mentally ill?
- smileypete 7y ago
unishark 7y ago
It also implies the decline of psychoanalysis was a bad thing, when it's basically pseudoscience.
- mnemonicsloth 7y ago
  If you mean Freudian psychoanalysis, you're right. Freud was a quack. The word "pseudoscience" was literally coined just to describe him. If you mean all psychotherapy is bullshit, you're wrong. There are bad therapists just like with everything else, but good psychotherapists have saved a lot of lives over the years. And if, on the off chance, you think all therapy is bullshit despite never having had therapy yourself... well, nobody is that stupid, right?
  - harry8 7y ago
    Any citations?
    - superhuzza 7y ago
      This is a pretty strong starting point: https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=Combined+pharmacotherapy+and+psychological+treatment+for+depression%3A+a+systematic+review.&btnG= https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=Comb...
    - mnemonicsloth 7y ago
      Within the humanities there will probably always be a lot of people who love Freud because he lets them say subversive things about society. But in the sciences he’s been debunked. Any Psych 101 book will tell you his methods are no longer used. Their most direct descendant, psychodynamics, is very different from its ancestor. Within the sciences, check out Karl Popper’s work on falsifiability. Freud is his example of pseudoscience: it sounds smart, and it can explain lots of things in retrospect, but if you write down it’s predictions in advance they often don’t match outcomes. Practitioners don’t acknowledge this or try to correct it.
  - pelliphant 7y ago
ALittleLight 7y ago
Correct me if I'm wrong, but this is a review of a book that purports to make the case you're stating is not made here. That seems like a high bar for a review to me. Unless, do you mean you've read the book and the book fails to substantiate this claim?
- hyperpape 7y ago
  Obviously a review can't give the argument in its full detail, but that doesn't mean this presentation is good. Did the DSM-IV result in inaccurate diagnoses? Worse treatment? The review doesn't clearly state a single negative consequence. For that matter, reading the review, I can't even be sure if the book argues that the DSM-IV was bad, or if that's merely the review authors' opinion. I expect that kind of clarity from a review, and it's missing here. Or again, on the point about the DSM-IV being a response to Rosenthal, what I'd like to read is something along the lines of "Cahalan's book presents detailed evidence that the DSM-IV was [influenced/prompted by/etc] the reaction to Rosenthal's experiment". In defense of the reviewer: the worst issue might be a case where the title simply promises more than the article delivers. And the reviewer typically doesn't write their title, so it may be the editor who is to blame.
Merrill 7y ago
It no doubt aided the movement to deinstitutionalize patients with mental illness. Between 1955 and 1994, most state hospitals for the mentally ill were closed. This was done with the best of intentions, but the implementation led to the current mess where many severely mentally ill people are without adequate treatment and are homeless or imprisoned.
- aksss 7y ago
  There's a great graph[1] showing per capita US institutionalization rates from 1934-2000, differentiating between prison, mental institutions and the combined total. The aggregate rate of US institutionalization is about the same as it was in 1954ish, the holding pen has just changed. The graph is from a blog post on Volokh Conspiracy[2] about a paper from American Criminal Law Review [3] entitled "Is Mass Incarceration Inevitable" [1]https://d2eehagpk5cl65.cloudfront.net/img/q60/uploads/2019/10/temp-1.jpg https://d2eehagpk5cl65.cloudfront.net/img/q60/uploads/2019/1... [2] https://reason.com/2019/10/08/in-mass-incarceration-inevitable-part-2-much-smaller-is-still-very-large/ https://reason.com/2019/10/08/in-mass-incarceration-inevitab... [3] https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3436933 https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3436933
mnemonicsloth 7y ago
Did it set back psychiatric practice? Maybe not. But did the Rosenhan experiment set back the public perception of psychiatry? How could it not? If you remember that suicide hotlines are life-saving interventions, and that a lot of don't call them because they think they're staffed by "head-shrinkers"... At the very least, Rosenhan convinced a lot of people that the Church of Scientology might be right about something. https://en.wikipedia.org/wiki/Scientology_and_psychiatry https://en.wikipedia.org/wiki/Scientology_and_psychiatry

peteretep 7y ago

This is standard fare for the source. The Spectator generally pick one of the authors' bugbears (usually Muslims, The Left, or Political Correctness Gone Mad), write a beautifully written and entertaining piece, all the time aggressively mixing and conflating fact and fiction with a slightly sneering tone. For example: https://outline.com/nMzA8N https://outline.com/nMzA8N

hinkley 7y ago
Makes the site name a bit on the nose, doesn't it?

taurath 7y ago

How many mental hospitals were closed in the 80s due to this?

77pt77 7y ago
Not enough. This article is nothing but propaganda. These experts never explained why homosexuality was considered a mental illness and later that decision was reverted. Neither of those changes was ever justified. It's almost like those decisions are made with no objective criteria.
- deleted 7y ago
  [deleted]

hsyqiwgx 7y ago

The DSM is controversial because it's only scientific until political groups take interest. The trans community lobbied and bothered academics over the DSM's definition for Trans people until the academics threw up their hands and decided their funding wasn't good enough to justify having a spine and so the definition in the DSM was changed with a minimum of real science to justify it. That's psychology as a field in a nutshell.

ringzero 7y ago
Ah, so you’d also agree homosexuality is a mental illness that “political groups” lobbied to change? Because, from the perspective of someone who isn’t a conspiracy theorist or bigot, it looks like the DSM updated their definition as more research and academic interest rendered the old definition outdated.
- msla 7y ago
  There's an actual, interesting question here, away from the Culture War fighting, which we can have if we want it: How much of any academic field is due to the culture that field is immersed in, and how much is due to empirical evidence and people attempting to be unbiased? For example, there's the existence of Jesus Christ: Modern historians agree that there was a man named Joshua-son-of-Joseph who was a heretical rabbi in the First Century Middle East who got crucified by the local authorities. Why? Is it because the evidence for him is just that good, or is it because most scholars in Christian countries were Christian and, therefore, unapt to question their surrounding culture? With Jesus, it's because of the evidence, as it happens, but the question is there, and hooting it down does a disservice to larger questions all fields have to confront as they mature.
throwawayjava 7y ago
As society changes, what it means to be maladapted to that society also changes. It's amazing how many people will agree with that statement (because... duh) and then freak out when someone points out it's impossible to talk about the DSM without talking about dominant beliefs regarding "what society should be like". I.e., without talking about politics and labor economics. There are many topics covered by the DSM that are maladaptations to this society but a) would not have been maladaptations in previous soecieties, and b) might not be maladaptations in future societies. Is it even possible to talk about something like whether some particular aspect of human sexuality is a disorder using only "real science", and on a related note, what does "real science" mean here? E.g., there have certainly existed human societies with no strong taboo around human nakedness, and in those societies Exhibitionistic Disorder wouldn't even make any sense to talk about. Similarly, it'd hard to imagine ADD being anything other than a perfectly normal non-maladaptive variation in personality prior to industrialization. As a practicing scientist, I'm honestly not sure how "real science" is supposed to given an answer a question like 'is being transexual maladaptive?" It's just not a scientific question. There are lots of related scientific questions about human biology. But ultimately, it's a question about how those biological facts interact with social constructions. Can you tell me, concretely, what you mean by "real science" here?

s1artibartfast 7y ago

Yeah, I wish the article was more clear on why Rosenhan's article was important and what exactly is claimed in The Great Pretender. Re-reading the article, It seems to suggest that it undermined public trust in forced psychiatric treatment. I can only guess that the author believes this was for the worse and is the titular setback?

smileypete 7y ago
Late to this; but here's a Q&A with the author which may shed some light: https://www.c-span.org/video/?466007-1/qa-susannah-cahalan https://www.c-span.org/video/?466007-1/qa-susannah-cahalan

ttctciyf 7y ago

Interestingly, the article makes no mention of the followup experiment where it seems a hospital invited a repetition and then claimed to have found 40 or so fake patients during the agreed period. Only to be told that the experimenters had sent none. Or at least that's the version told in Adam Curtis' documentary The Trap (part 1)[1] which engages in Curtis's usual enthusiasm for fashioning a sweeping historical narrative out of somewhat sparse materials - in this case presenting the "Thud" experiment and its followup as a pivot point in the tale of how R. D. Laing's anti-psychiatry ironically led to the advent of the DSM IV era. However that may be, if Curtis' account of the followup is correct it seems harder to argue the diagnostic prowess of the psychiatrists was not open to question, regardless of the status of the original experiment. 1: In the section beginning here: https://youtu.be/y97Ywl7RtUw?t=2204 https://youtu.be/y97Ywl7RtUw?t=2204

77pt77 7y ago
> Interestingly, the article makes no mention of the followup experiment where it seems a hospital invited a repetition and then claimed to have found 40 or so fake patients during the agreed period. The reason is simple. This article is pure propaganda along the lines of the book "The great pretender" by Susannah Cahalan. The experiment might have flaws, but this second part is conclusive and no critics ever address it. This is just another brick on the long propaganda road to a destination that is very worrisome.
- warbaker 7y ago
  My default position on the follow-up is likewise skepticism. It seems like the filters at the time were so low that it is likely the follow-up is just a better constructed lie.
  - 77pt77 7y ago
    What about the argument, used at the time, that in order for someone to participate in an experiment like that they had to be mentally ill?
smileypete 7y ago

unishark 7y ago

It also implies the decline of psychoanalysis was a bad thing, when it's basically pseudoscience.

mnemonicsloth 7y ago
If you mean Freudian psychoanalysis, you're right. Freud was a quack. The word "pseudoscience" was literally coined just to describe him. If you mean all psychotherapy is bullshit, you're wrong. There are bad therapists just like with everything else, but good psychotherapists have saved a lot of lives over the years. And if, on the off chance, you think all therapy is bullshit despite never having had therapy yourself... well, nobody is that stupid, right?
- harry8 7y ago
  Any citations?
  - superhuzza 7y ago
    This is a pretty strong starting point: https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=Combined+pharmacotherapy+and+psychological+treatment+for+depression%3A+a+systematic+review.&btnG= https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=Comb...
  - mnemonicsloth 7y ago
    Within the humanities there will probably always be a lot of people who love Freud because he lets them say subversive things about society. But in the sciences he’s been debunked. Any Psych 101 book will tell you his methods are no longer used. Their most direct descendant, psychodynamics, is very different from its ancestor. Within the sciences, check out Karl Popper’s work on falsifiability. Freud is his example of pseudoscience: it sounds smart, and it can explain lots of things in retrospect, but if you write down it’s predictions in advance they often don’t match outcomes. Practitioners don’t acknowledge this or try to correct it.
- pelliphant 7y ago

ALittleLight 7y ago

Correct me if I'm wrong, but this is a review of a book that purports to make the case you're stating is not made here. That seems like a high bar for a review to me. Unless, do you mean you've read the book and the book fails to substantiate this claim?

hyperpape 7y ago
Obviously a review can't give the argument in its full detail, but that doesn't mean this presentation is good. Did the DSM-IV result in inaccurate diagnoses? Worse treatment? The review doesn't clearly state a single negative consequence. For that matter, reading the review, I can't even be sure if the book argues that the DSM-IV was bad, or if that's merely the review authors' opinion. I expect that kind of clarity from a review, and it's missing here. Or again, on the point about the DSM-IV being a response to Rosenthal, what I'd like to read is something along the lines of "Cahalan's book presents detailed evidence that the DSM-IV was [influenced/prompted by/etc] the reaction to Rosenthal's experiment". In defense of the reviewer: the worst issue might be a case where the title simply promises more than the article delivers. And the reviewer typically doesn't write their title, so it may be the editor who is to blame.

Merrill 7y ago

It no doubt aided the movement to deinstitutionalize patients with mental illness. Between 1955 and 1994, most state hospitals for the mentally ill were closed. This was done with the best of intentions, but the implementation led to the current mess where many severely mentally ill people are without adequate treatment and are homeless or imprisoned.

aksss 7y ago
There's a great graph[1] showing per capita US institutionalization rates from 1934-2000, differentiating between prison, mental institutions and the combined total. The aggregate rate of US institutionalization is about the same as it was in 1954ish, the holding pen has just changed. The graph is from a blog post on Volokh Conspiracy[2] about a paper from American Criminal Law Review [3] entitled "Is Mass Incarceration Inevitable" [1]https://d2eehagpk5cl65.cloudfront.net/img/q60/uploads/2019/10/temp-1.jpg https://d2eehagpk5cl65.cloudfront.net/img/q60/uploads/2019/1... [2] https://reason.com/2019/10/08/in-mass-incarceration-inevitable-part-2-much-smaller-is-still-very-large/ https://reason.com/2019/10/08/in-mass-incarceration-inevitab... [3] https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3436933 https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3436933

mnemonicsloth 7y ago

Did it set back psychiatric practice? Maybe not. But did the Rosenhan experiment set back the public perception of psychiatry? How could it not? If you remember that suicide hotlines are life-saving interventions, and that a lot of don't call them because they think they're staffed by "head-shrinkers"... At the very least, Rosenhan convinced a lot of people that the Church of Scientology might be right about something. https://en.wikipedia.org/wiki/Scientology_and_psychiatry https://en.wikipedia.org/wiki/Scientology_and_psychiatry