Critical Evaluation of Rosenhans Study 'on Being Sane in Insane Places'

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The question of what it means to be labelled ‘psychologically abnormal’ is examined closely in Rosenhans study of ‘On Being Sane in Insane Places’. This study highlights the usefulness and consequences of being diagnostically labelled.

Rosenhans study ‘On Being Sane in Insane Places’ tests the hypothesis that ‘We cannot distinguish the sane from the insane in psychiatric hospitals’. (Rosenhan, 1973) This study is an influential criticism in testing the validity of psychiatric diagnoses, contextual factors in reaching these diagnoses, and what happens after a patient has been diagnostically labelled as ’psychologically abnormal’. The aim of Rosenhans study was to prove a positive hypothesis. During the study 8 participants of various backgrounds, including Rosenhan himself, gained admission in to 12 psychiatric hospitals across the US. These hospitals were a random selection, from research based to private, modern, old and with varied staff-patient ratios. The pseudo patients gained entry to the facilities by feigning that they could hear voices, reflective of a personality disorder, including words such as ‘hollow’ and ‘empty’. These words were selected by Rosenhan as an opportunity to demonstrate that these voices might be reflecting on the individual’s life. After admission to the hospital Rosenhan claims that the pseudo patients cease any abnormal behaviour and continue life within the institution and normally as possible. Rosenhan instructs the pseudo patients to not alter any personal information about themselves to the staff of the hospital such as their education or family background (except their name for security purposes) whilst being psychologically assessed. The study tests whether the patients, after their original symptoms have alleviated, will be given a psychiatric diagnoses and the consequences of being labelled as such. The outcome of the study was that 11 out of 12 participants were discharged as having ‘Schizophrenia, in remission’. Rosenhan closely explores the penalties of being labelled by these diagnoses. Lack of recognition of the sanity of the pseudo patients is key in Rosenhans argument for the validity of his study. Rosenhan is excessively criticised for his findings, and although proving that there is room for further development in psychiatric diagnoses, many discredit his study and question its validity and reliability. There are also many ethical questions that should be looked at closely when critiquing his work(Rosenhan, 1973).

Rosenhan highlights key findings in his study, which directly relate to being viewed as ‘psychologically abnormal’. The most valid points he looks at are as follows: the unreliability of psychiatric diagnoses, the effects of diagnostic labelling and how contextual factors influence how these are viewed, and the further effects on patients being labelled, such as, becoming powerless (Rosenhan, 1973). By focusing on these areas Rosenhan brings to light many important questions, such as, how valuable are psychiatric diagnoses? If there is any room for doubt, then in turn, how reliable are our legal systems that support these? Rosenhans study is an important framework for examining these issues further and the evidence he presents greatly support the notion that there are real consequences of being diagnostically labelled, but also how easy it is to do so. This is brought to light by the staff in the hospitals using the pseudo patient’s diagnoses in context when assessing their past (Rosenhan, 1973).

From the outset of Rosenhans study he leaves room for criticism, any many focus directly on his hypothesis. Without the use of a correctly used hypothesis his experiment reduces in validity. An article written by Millon comments that not only does Rosenhans hypothesis have ‘misused terms’ such as ‘sane’ and ‘insane’ which are not politically correct, but he claims his hypothesis is proved correct, which is largely debatable. Millon critiques this by suggesting that...
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