➿ The Great Pretender: The Undercover Mission That Changed Our Understanding of Madness Free ➶ Author Susannah Cahalan – Waspnestremovalservices.co.uk

The Great Pretender: The Undercover Mission That Changed Our Understanding of Madness When I read Brain on Fire, Susannah Cahalan s memoir about her experience with psychosis, I became a little obsessed with it The Netflix adaptation was disappointing, as the clever hook in the book was her investigating her own illness from an outside perspective, something she could do as she lost most of her memory from when she was sick The film just follows it straight But that s a digression Brain on Fire is an extremely readable memoir about a very scary and rare thing that happened When I read Brain on Fire, Susannah Cahalan s memoir about her experience with psychosis, I became a little obsessed with it The Netflix adaptation was disappointing, as the clever hook in the book was her investigating her own illness from an outside perspective, something she could do as she lost most of her memory from when she was sick The film just follows it straight But that s a digression Brain on Fire is an extremely readable memoir about a very scary and rare thing that happened to Cahalan Especially since the extremely rare illness she was diagnosed with anti NMDA receptor encephalitis, an autoimmune disease that at the time had only been diagnosed in a couple hundred people, ever is a kind of disorder that is sometimes called a great pretender, meaning it mimics the symptoms of other diseases and is thus hard to diagnose In this case, Cahalan s body was attacking her brain, but doctors believed she was mentally ill After recovering from her illness, Cahalan became obsessed with what could have been, or the people she began to call her mirror images One woman in particular was diagnosed with the same rare disorder after her doctor attended a lecture that Cahalan gave, but she had been suffering with the condition for years at that point, and even after treatment, would never be able to fully recover as Cahalan was able to, because she was incredibly lucky and diagnosed so early Cahalan s is full of encounters like this now, as talking about mental illness with strangers has become a regular occurrence When an acquaintance brought up David Rosenhan s infamous study from the 1970s, where he sent eight pseudopatients undercover into psychiatric hospitals to test out psychiatry s ability to tell the sane from the insane, and to question the efficacy of psychiatric diagnosis, Cahalan immediately wanted to learn everything she could Rosenhan s study became a phenomenon when it was published, crossing over into the mainstream media, and altering the practice of psychiatry in pretty significant ways.Cahalan began digging into the story, determined to learn about Rosenhan, track the effects of the study, and maybe track down the pseudopatients themselves they were given pseudonyms in the published paper, which was titled On Being Sane in Insane Places But as she starts her digging, she gradually comes to realize there are enormous holes in the story, and Rosenhan and his study were not what they seemed I don t want to saythan that, because it s fun to watch her chase down clues, and uncover what actually happened.Cahalan also uses the investigation into the study to look into the history of psychiatry itself This was one of the main things I m ambivalent about with the book At times it felt scattered, as other reviewers have pointed out, she follows a lot of tangents I keep going back and forth about whether those tangents were actually tangents at all, but instead purposeful insights into a greater picture that Cahalan was trying to present But it was still a little messy and confused in execution I think I would have appreciatedclarity But I do think it was a necessity for her to not write about this study in a bubble You need to know about a lot of it to understand the impact the study had on the field, and why it feels like such an urgent topic still today to Cahalan.It was very unsettling throughout the book to realize just how much we still don t know about mental illness, as one psychiatrist she quotes in the book says, all we have are signs and symptoms, and though other reviewers have accused Cahalan of an anti psychiatry bias, I don t think that s what s going on here at all She s certainly in favor of psychiatry practices that don t dehumanize patients, and in favor of science that advances our understanding of the brain and how it works She s also not afraid to bring up sticky questions, like how the mental illness stigma and cognitive bias often leads to misdiagnosis, and how disorders that have a physical cause in the body are taken so muchseriously than the murkier conditions like bipolar or schizophrenia, or even clinical depression She definitely is advocating for an approach that eliminates the distinction between a medical diagnosis and a mental one she argues that mental diagnoses are medical, even if we don t yet understand the causes Her own case is pretty damning she says the way she was treated was markedly different after she received her medical diagnosis, as compared to how she was treated when doctors thought she might have schizoaffective disorder, or maybe she was just partying too much One of the things I found fascinating about the book was that even as Rosenhan s study exposed flaws in the system, and produced massive change a new standardized approach to diagnosis in the DSM III for one thing , it also had massive consequences for the future of institutionalized psychiatry There was already a growing anti psychiatry movement in full swing by the time the study was published, one of the reasons it hit so big, and afterwards, many hospitals were closed, and those that are now left are massively underfunded The need for psychiatric beds, according to Cahalan, is at minimum 95,000 heads in the USA It is easier to get into Harvard in some cases than to get a bed and treatment when it is needed Something I didn t know before this was that JFK s sister, Rosemary, had a developmental disorder due to oxygen deprivation at birth, and what ended up happening to her was so horrific, JFK decided to devote himself to the idea of ending barbaric practices on patients like lobotomies and to promote community care with government funding aholistic approach that focuses on humanizing patients But because he was assassinated, the only part of his plan to be put into effect was the closing of hospitals, and the funding for different types of programs never materialized.Despite it s scattered ness, I m really glad I read this, and I hope people who can make a difference in our mental health care system will also read it 3.5 stars, rounding up Instagram Twitter FacebookPinterestI was so excited to read this book because I loved her first book, BRAIN ON FIRE, which was her own journalism style memoir chronicling her experience with autoimmune encephalitis that manifested itself with symptoms similar to schizophrenia Had she been misdiagnosed, she could have ended up with permanent brain damage or dead Given that close call, it s understandable that the author might have some skepticism about psychology A lo Instagram Twitter FacebookPinterestI was so excited to read this book because I loved her first book, BRAIN ON FIRE, which was her own journalism style memoir chronicling her experience with autoimmune encephalitis that manifested itself with symptoms similar to schizophrenia Had she been misdiagnosed, she could have ended up with permanent brain damage or dead Given that close call, it s understandable that the author might have some skepticism about psychology A lot of people do, and like a lot of sciences, its beginnings seem backwards and barbaric Of course, since psychology is one of the newer sciences, those beginnings are farrecent than most.THE GREAT PRETENDER is about the Rosenhan experiment, a study in which volunteers including the psychologist leading it pretended to have vague symptoms and see if they would get checked in to a mental health facility Spoiler according to the researcher s notes, all of them did, and all of them except for one ended up with diagnoses of schizophrenia the other was diagnosed as borderline, I think, or manic Also spoiler they found the conditions pretty horrible, too Staff were unsympathetic and liable to treat even normal behaviors such as journaling as mentally ill.Cahalan manages to get access to the psychologist s notes and even interview some of the participants in the study Her findings, through supplementary research and some historical context, are pretty grim on both sides Yes, clinical psychologists have, historically, done some pretty awful things in the name of medical science, whether it s treating patients like circus acts 19th century Bedlam or doing gratuitous surgeries assembly line style, to those who are willing and not lobotomies Cahalan talks about a Victorian journalist who checked herself in to a psychiatric facility and was horrified by the results Rosenhan and his experimenters, while finding themselves in conditions nowhere near as horrifying, were still shocked at their cold and impartial and sometimes unhygienic treatment.When the study came out, people immediately sought to riposte it Psychology is an oft villainized field and I think there was probably a concern that a distrust in the industry might dissuade people from seeking the treatment they might need Less philanthropically, I m sure they were also concerned for their careers and the cash money said careers brought in As Cahalan notes, the study may not have been as truthful as it could have been, as there were some factual disputes that arose when his data was cross referenced with interviewees and other sources.I wanted to like this book a lotthan I did, being that I was a psychology major in school and actually contributed to active research studies Supposedly, there s even one floating around out there with my name on it Initially, I was very interested in the subject of the experiment, but it quickly wore thin as it was much drier than I was expecting and the whole time I was reading, I kept comparing THE GREAT PRETENDER unfavorably to the author s first book I do think if you want to read a book that goes into depth about what psychiatric clinics are like, as well as the ethics of psychology and treatment, you might enjoy it, but those who aren t interested in psychology and have only scant interest in the topic will be disappointed, as this is hardly titillating and textbook dry.Thanks to the publisher for sending me a copy in exchange for an honest review 2 to 2.5 stars From One Of America S Most Courageous Young Journalists NPR Comes A Propulsive Narrative History Investigating The Year Old Mystery Behind A Dramatic Experiment That Changed The Course Of Modern Medicine For Centuries, Doctors Have Struggled To Define Mental Illness How Do You Diagnose It, How Do You Treat It, How Do You Even Know What It Is In Search Of An Answer, In The S A Stanford Psychologist Named David Rosenhan And Seven Other People Sane, Normal, Well Adjusted Members Of Society Went Undercover Into Asylums Around America To Test The Legitimacy Of Psychiatry S Labels Forced To Remain Inside Until They D Proven Themselves Sane, All Eight Emerged With Alarming Diagnoses And Even Troubling Stories Of Their Treatment Rosenhan S Watershed Study Broke Open The Field Of Psychiatry, Closing Down Institutions And Changing Mental Health Diagnosis Forever But, As Cahalan S Explosive New Research Shows, Very Little In This Saga Is Exactly As It Seems What Really Happened Behind Those Closed Asylum Doors, And What Does It Mean For Our Understanding Of Mental Illness Today Why I love itby Maris KreizmanSusannah Cahalan was not okay Over the course of a month she went from being a fully functioning young reporter to suffering from psychosis and hallucinations, a step away from being diagnosed with schizoaffective disorder In her devastating 2012 memoir, Brain On Fire, Cahalan details how a neurological disease not only caused her body to attack her brain, but also caused her to question her own sanity.Susannah is fully recovered now, but what would have happened Why I love itby Maris KreizmanSusannah Cahalan was not okay Over the course of a month she went from being a fully functioning young reporter to suffering from psychosis and hallucinations, a step away from being diagnosed with schizoaffective disorder In her devastating 2012 memoir, Brain On Fire, Cahalan details how a neurological disease not only caused her body to attack her brain, but also caused her to question her own sanity.Susannah is fully recovered now, but what would have happened to her if her diagnosis of mental illness had stuck This is what she grapples with in The Great Pretender, an engrossing history of the study of mental illness, centered around an experiment in which a psychiatrist and a group of other healthy people get themselves committed to mental hospitals in the early 1970s There they experience the dehumanizing, traumatizing nature of the institutions themselves, and ultimately discover firsthand how mental illness diagnoses are biased and arbitrary at best.How do we decide who is mentally ill Drawing on years of archival research as well as her own personal experiences, Cahalan s gripping account of the history of insanity is a feat of both enjoyable storytelling and skillful reporting.Readat If you re going into this book expecting an in depth rehashing of the Rosenhan experiment and its conclusions, you may be disappointed I hold a BA in psychology, so I was already somewhat familiar with this study going into the book While I did get some new information from The Great Pretender, it was not nearly as much as I d hoped Part of the reason for this is that the focus of the book is not super specific The synopsis from the publisher gave me an impression of a very different book th If you re going into this book expecting an in depth rehashing of the Rosenhan experiment and its conclusions, you may be disappointed I hold a BA in psychology, so I was already somewhat familiar with this study going into the book While I did get some new information from The Great Pretender, it was not nearly as much as I d hoped Part of the reason for this is that the focus of the book is not super specific The synopsis from the publisher gave me an impression of a very different book than I read.Another reviewer who enjoyed the book a lot less than I did made the comment that it felt like Cahalan did a lot of research on peripheral topics for this book and didn t want it to go to waste Consequently, it all gets included While I get where this person is coming from, I disagree A lot of the history of psychology included in this leads directly into David Rosenhan s reasoning for conducting his famous experiment He sent healthy pseudo patients into mental hospitals for two major reasons to expose the hazy nature of psychological diagnostic criteria as they existed at the time, and to provide witnesses who would be palatable to the general public who could relay the treatment the mentally ill were receiving in these institutions The historical backdrop did not feel superfluous.Cahalan also delves into several other famous experiments, again indetail than I would have expected given the blurb s focus on Rosenahn These major experiments are also relevant, albeit in a tangential way, because of the controversy surrounding them The Stanford Prison Experiment Philip Zimbardo and Stanley Milgram s experiment on obedience to authority These experiments also share some thematic similarities with Rosenhan s work all of them explore the darker side of human nature in varying respects Zimbardo purported to show that the overwhelming majority of people are capable of horrifically abusive behaviors towards another person in dehumanizing, institutional settings like prisons Milgram s experiment had an authority figure in a lab coat asking participants to administer electric shocks to people as part of an experiment on the effects of punishment on learning The teaching experiment was actually a smokescreen, and the true purpose was to see how many people would agree to shock someone who was in pain, and to what degree.All three of these experiments Rosenhan s, Zimbardo s, and Milgram s have faced sharp criticism of their methodology, with Zimbardo facing probably the most scrutiny Issues vary from the potentially inappropriate level of manipulation on the participants from the researcher to outright deceit.Cahalan s book explores a variety of issues surrounding psychiatry in a good amount of detail, some only tangentially related to the experiment referenced in the title If your interest in this book is primarily out of a desire to understand Rosenhan s research, you may end up feeling like you are wading through a lot of unneeded information in order to get it However, if you have ageneral interest in psychology and psychiatry, this may be an excellent book for you.You can read all of my reviews on my blog, Jenna Bookish Facebook Instagram Tumblr Very disappointing This book is rather poorly written and its approach is exceedingly scattered In my opinion, the author is not really qualified by either education or experience to write about the topics discussed The actual purpose of the work remains elusive to the reader Cannot recommend either the purchase or taking the time to read this. Book Blog BookstagramOpening Thesis Everyone needs drugsMain Diagnosis SCHIZOPHRENIAPlot Researchy ness Up to your eyeballs in straight FACTSBefore you go into reading this book, you must first understand the true premise It is NOT a history of psychiatry and psychiatric hospitals, though those things are discussed to fully understand what Dr David Rosenhan was doing But this book is almost totally about Dr David Rosenhan and his study from the 1970s that looked to expose how psychiatry Book Blog BookstagramOpening Thesis Everyone needs drugsMain Diagnosis SCHIZOPHRENIAPlot Researchy ness Up to your eyeballs in straight FACTSBefore you go into reading this book, you must first understand the true premise It is NOT a history of psychiatry and psychiatric hospitals, though those things are discussed to fully understand what Dr David Rosenhan was doing But this book is almost totally about Dr David Rosenhan and his study from the 1970s that looked to expose how psychiatry was functioning away from public knowledge.I admit I was kind of disappointed once Nellie Bly was discussed for only a couple of paragraphs because that is shit I showed up for I was expecting a novel that discussed people like Blyin depth I was expecting something a bitsinister and historical Like, give me some Geraldo Rivera at Willowbrook kind of drama.But alas, it wasn t meant to be.Once I got passed my assumptions, I did get into this nonfiction work, but not as much as I was hoping I would It s a pretty dense read, full of medical jargon, medical history seriously, you go through the creation of all the DSM volumes and a complete dissection and recounting of Dr Rosenhan s study, On Being Sane in Insane Places.The gist is this David Rosenhan, a psychologist and Stanford University professor, was not all in on his profession and saw psychiatry as a having taken to a dangerous path He believed people were over diagnosed, over medicated and that the definitions of mental health issues were too broad and unreliable.He conceived of his experiment as a way to test that reliability, checking himself into a mental ward undercover, claiming to hear voices and have other hallucinations He wanted to see if the doctors, nurses and staff would be able to figure out he was lying They couldn t He was instead diagnosed as schizophrenic and heavily medication like the drooling and not able to talk kind of medicated He only ever swallowed the meds once, on accident After he was discharged, Rosenhan expanded the study, bringing on seven other pseudo patients to go undercover, all at different psych hospitals and wards Rosenhan came to the conclusion that psychiatrists and psychiatric hospitals were completely unable to sort the insane patients from the sane ones.Once someone was deemed to be insane, all of their actions, even if perfectly normal behaviours, were seen as crazy because everything was being viewed through the lens of being formally diagnosed The study was published by the journal Science in 1973 and effectively caused the entire psychiatric field to reevaluate, take sides and come under scrutiny.Without giving anything away, despite this not being what I thought the majority of the book was going to be about, the story of David Rosenhan s experiment was hella interesting and has a few shocking little twists.Basically, it all comes down to an Oprah style moment of YOU GET SCHIZOPHRENIA YOU GET SCHIZOPHRENIA EVERYONE GET SCHIZOPHRENIA But like I said, this book is dense with information, and it s not only information about Rosenhan s study and Cahalan s complete investigation into every aspect of it.Any time a point is raised, Cahalan takes a detour and pours out all her research onto that detour topic It s very clear she completely immersed herself into everything having to do with psychiatry and it s history and current status, and that she didn t want to edit out any of it She found a spot for everything last quote and topic, causing the narrative to sometimes feel like Cahalan was jamming a square peg of information into the round hole of the plotline.The Esalen Institute, JFK s family history and his dedication to ending barbaric psychiatric practices like lobotomies issues of replicability in research and using prisons as defacto psych wards for criminals who should really by in genuine psych wards these are all topics that we meander onto at some point It s all worth the brainpower to read, I feel like I learned a lot even if I can t say it totally stuck But the reading experience as a whole can feel like a slog to get through with so much constant information to wade through.My main takeaway from this is that we basically still know jackshit about mental health and how to treat it It s a sobering, scary and frustrating topic to delve so deeply into, but despite it s scattered flow, Cahalan did a hell of a job getting me to read something through to the end that I would normally have abandoned because I hate learning things or whatever 4 stars I love non fiction I love psychology I thought I was going to love this book I was wrong.I hate that I found this book so very disappointing The author states the book is about Rosenhan and his pseudopatient study which I was excited to learnabout after it was mentioned briefly during my undergrad degree Maybe 1 1 2 chapters is about Rosenhan s experience in a psychiatric hospital along with a few experiences mentioned by the other pseudopatients This book is mostly a history of psyc I love non fiction I love psychology I thought I was going to love this book I was wrong.I hate that I found this book so very disappointing The author states the book is about Rosenhan and his pseudopatient study which I was excited to learnabout after it was mentioned briefly during my undergrad degree Maybe 1 1 2 chapters is about Rosenhan s experience in a psychiatric hospital along with a few experiences mentioned by the other pseudopatients This book is mostly a history of psychiatry which is okay, but most definitely not what the author claimed it to be about.The writing is also hard to follow The author starts a paragraph on one topic and then follows several rabbit trails, going on rants and in depth discussion on another semi related matter before finally finishing the original paragraph three page later Unfortunately, I really can t recommend this book to anyone and I m sad I wasted a Book of the Month credit on it Back in the early 1970s, Dr David Rosenhan published the results of a study wherein he and several other people so called pseudopatients , none of whom had ever had mental health issues, attempted to get admitted to psychiatric hospitals by showing up and claiming they heard a voice in their head saying empty, hollow, and thud All of them got admitted on this basis, most of them receiving a preliminary diagnosis of schizophrenia Once admitted, they behaved like their normal selves, b Back in the early 1970s, Dr David Rosenhan published the results of a study wherein he and several other people so called pseudopatients , none of whom had ever had mental health issues, attempted to get admitted to psychiatric hospitals by showing up and claiming they heard a voice in their head saying empty, hollow, and thud All of them got admitted on this basis, most of them receiving a preliminary diagnosis of schizophrenia Once admitted, they behaved like their normal selves, but no one seemed to notice they were actually not mentally ill The resulting article, On Being Sane in Insane Places, purported to show that 1 diagnosis of mental health issues was unreliable at best and 2 patients in psychiatric hospitals were in fact not treated in ways that might actually be therapeutic.When Susannah Cahalan heard about this study a few years ago, she was fascinated Girl, me too Rosenhan s study put me in mind of Nellie Bly s groundbreaking undercover investigation of an asylum, which she published in the 1880s as Ten Days in a Mad House, and which I was obsessed with as a kid Bly s investigation is detailed in The Great Pretender, but Cahalan s own interest was based on somethingpersonal Her harrowing experience of having her brain inflammation misdiagnosed as mental illness If a determined doctor hadn t discovered what was actually ailing her, her life may have turned out very differently.Cahalan decided to find out everything she could about Rosenhan s study, talking to his associates and even attempting to track down some of the other pseudopatients who took part in it Without spoiling anything, what she discovered was very interesting, and The Great Pretender itself should have been similarly interesting Unfortunately, this book had so many structural problems it was ultimately muchfrustrating than fascinating.Simply put, Cahalan should have made the Rosenhan study, how it was received, and her investigation into it the main plotline of the book But she clearly did a ton of research and didn t want any of it to go to waste, so there are many, many detours, for paragraphs, pages, or even entire chapters, into topics that are peripheral the history of the Esalen Institute, for example and or can t be discussed adequately here overdiagnosing replicability issues in research imprisoning the mentally ill Some of these details actually undermine the points she is trying to make for example, she wants to claim that Rosenhan s study caused the closure of psychiatric hospitals, resulting in a lack of support for the mentally ill, but a long detour into John F Kennedy s efforts to help the mentally ill shows that this was a problem well before Rosenhan came on the scene All of this extra information not only makes the reading experience a slog it also dulls the impact of the discoveries Cahalan herself makes I truly wish someone had edited this book with an eye toward making it sharper andconcise it would have made the book ainformative and memorable reading experience.Cahalan understandably takes issue with the vague misdiagnosing that caused the pseudopatients to end up hospitalized, but she seems equally opposed to the muchdetailed diagnostic criteria provided by DSM volumes that have appeared subsequent to the Rosenhan study Does Cahalan offer her own solution to these problems In a word, no in the penultimate chapter of The Great Pretender she rails against the psychiatry and psychology professions in a way that s nearly incoherent, and in the final chapter she purports to offer hope for the future, but some of the advances she names seem like quackery and pseudoscience, and the fact that psychiatrists are makingmoney than ever before hardly seems like the good news she thinks it is.The book is also sloppy with facts in a way that gave me pause She misuses the word metastasize, for example, and indicates that mammograms prevent breast cancer they don t, of course She also makes much of the fact that Rosenhan published his article in Science rather than aspecialized journal, implying that Science would be less rigorous in its review and that its quick turnaround times necessarily meant its peer review process cut corners This implication struck me as irresponsible it seems equally likely that Rosenhan wanted to be in Science because it was a prestigious and popular journal, and that its faster peer review process might be a result of its large number of resources compared to other journals I was left with the feeling that Cahalan, a former New York Post reporter, didn t know much about scientific publishing, and it made me wonder what else was mere speculation on her part.Some criticisms with the presentation of the book The Rosenhan article itself wasn t included here neither were the responses to the study that other researchers published Sure, it would have cost money for the publisher to obtain these reprint rights, but it would have made the entire experience of reading The Great Pretender muchinformative Additionally, Cahalan urges readers to educate themselves on these issues, but she doesn t include a list of recommended reading instead readers are expected to wade through the end notes for pertinent material None of this adds up to a satisfactory learning experience.As I said, this topic is fascinating to me, and it saddens me that I can t recommend this book In short, the whole thing should have been wayincisive The less pertinent info should have been edited way down Cahalan s unfocused screeds should have been shortened and made, well,focused andresources should have been provided for the reader It seems that The Great Pretender is meant to be some kind of challenge to the field of psychiatry to do better, and while that s a worthy goal, Cahalan hasn t done much here besides meet their fuzzy thinking with fuzzy thinking of her own.I received this ARC via a Shelf Awareness giveaway Thank you to the publisher Have read Susannah Cahalan s deeply personal memoir, Brain on Fire She has followed up that best selling book with The Great Pretender, which exposes the suspenseful mystery behind an experiment that shaped modern medicine and mental health as we know it today David Rosenhan and his brave colleagues entered asylums undercover in order to come out diagnosed out the yin yang, but better able to expose the atrocities and systemic problems in mental health treatment at the time On top of that, Ca Have read Susannah Cahalan s deeply personal memoir, Brain on Fire She has followed up that best selling book with The Great Pretender, which exposes the suspenseful mystery behind an experiment that shaped modern medicine and mental health as we know it today David Rosenhan and his brave colleagues entered asylums undercover in order to come out diagnosed out the yin yang, but better able to expose the atrocities and systemic problems in mental health treatment at the time On top of that, Cahalan exposes the untold mystery within the mystery.I received a complimentary copy from the publisher.Many of my reviews can also be found on instagram www.instagram.com tarheelreader

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