If you are locked up in a psychiatric hospital, how can you prove to the doctor that you are not sick among the many mentally ill people?
Some people will say that I am a normal person, certainly not the same as a mental patient who behaves like crazy, and doctors and nurses are not stupid, how can I not tell the difference.
I believe that most people will have such a thought, there was a joke, a well-known reporter went to a local psychiatric hospital for an interview.
During the interview, the reporter asked the dean: "How do you judge that the patient has been cured?" ”
The dean smiled and said, "Very simply, we will fill a large bathtub with water, then put a spoon and a basin next to it, and ask them to drain the water in the bathtub as quickly as possible." ”
The reporter suddenly realized and said triumphantly.
"As it turns out, normal people would have used a basin to scoop water out instead of a spoon, right?"
"No, normal people pull out the cork under the bathtub." Dean said.
Although it is just a joke, it reflects a real question, that is, can doctors really distinguish between mentally ill people and normal people?
As early as 49 years ago, David Rosenhann did a similar experiment, and the results of the experiment are believed to surprise many people.
01 Normal people in mental hospitals
Born in Jersey City, New Jersey, in 1929, David Rosenhann taught at Swarthmore College in the United States after receiving his Ph.D. from Yeshwa University.
In the psychology class, Rosenhann was talking, but the students in the audience were listening in the clouds.
Some students complained that his classes were too abstract, and Rosenhann, far from being angry, was inspired.
Therefore, Rosenhann decided to go to the mental hospital to experience the life of a mentally ill person, and after 9 days of difficult living in the dark hospital, Rosenhann really couldn't hold on.
However, these nine days are not all for nothing, in these few days, Rosenhann deeply experienced the darkness of patients' lives, looking at many unprofessional nurses and doctors, Rosenhann suddenly had an idea in his head.
Can these so-called doctors really distinguish between mentally ill and normal people?
And when this bold idea took shape in his head, in 1973, a plan followed.
First, Rosenhann brought in eight normal people from society who volunteered to participate in the experiment, from all walks of life.
These include 3 psychologists, 1 graduate student, 1 psychiatrist, 1 pediatrician, 1 painter, and 1 housewife.
Several of them were normal people with healthy mental health and no history of genetic psychosis, and before the experiment began, they were asked not to take a shower for several days, not to cut their hair and nails, and to make themselves look as haggard as possible.
Finally, with the help of a lawyer, several people went to different psychiatric hospitals in the United States.
Some are large public hospitals, some are luxurious private hospitals, and their "symptoms" are the same, 8 people tell the doctor that they can often hear "buzzing" or "rumbling".
Because of the technical conditions at that time, it was impossible to distinguish whether what the patient said was true or false, and several people were also imprisoned in a mental hospital because of the so-called auditory hallucinations.
And the hospital finally came to a surprising conclusion by examining several people.
That's eight people, seven of whom were diagnosed with schizophrenia, while the other was considered manic.
The reason for his diagnosis of mania was even more bizarre, with doctors asking about the man's family and emotional status after being admitted to the hospital.
The man said that he and his wife have a good relationship, the two almost do not quarrel, the child is more sensible, occasionally will be naughty, he will teach him a lesson.
In the end, he was identified as manic and had a tendency to hurt people and a strong desire to control.
And after several people have successfully entered the mental hospital, the real experiment is about to begin.
In the hospital, several people behave like normal people, getting up, eating, and walking as usual every day, and everything is no different from the behavior when they are at home on weekdays.
So among the many psychopaths who behave strangely, will a few normal people be discovered by the doctor at a glance?
The results once again surprised everyone, and the normal behavior of the experimenters did not attract the attention of the doctors at all.
Sometimes, they walk down the hallway, which doctors would consider to be a sign of agitation.
One experimenter was left-handed and always used his right hand when eating, which would also be considered by doctors to be a manifestation of mental illness.
Since several experimenters have to record the day's daily routine every day, they carry a small book with them.
Once, while an experimenter was intently writing a record of an experiment, a doctor suddenly appeared next to him.
The experimenter was shocked, just when he thought that the matter was exposed, he did not expect that the doctor did not see what he wrote, but lightly opened the medical record book and wrote "nervousness, scribble" in the symptom column.
If you confess to the doctor that you are not sick and that everything is in disguise, then they will think that you are talking nonsense or delusional.
Once you are emotional and trying to explain that you are a normal person, you will be considered violent and a sedative will hit you in the arm.
02 Rosenhann Experiment
Such an unscientific diagnosis is absurd and terrifying, which is reminiscent of the plot of the movie "Leaping Madhouse".
The male protagonist in the movie, Mike, in order to avoid the punishment of the prison, disguised as a mental illness was put in prison, under the management of the arbitrary head nurse, all the actions of the patients must be strictly in accordance with her command.
Such a depressed life naturally caused Mike's dissatisfaction, so he would secretly take the sick people to play, watch games, and hold entertainment.
Gradually, smiles appeared on the patients' faces, but this angered the head nurse, who thought Mike's arrival had jeopardized her position.
Once, a patient commits suicide because of the cold blood of the head nurse, and an enraged Mike grabs the head nurse by the neck, trying to end the demon's life, but then the arriving security guard knocks him down with a stick.
By the time he woke up, he was already tied to a hospital bed, and although he had repeatedly stressed that he was not mentally ill and that he was pretending, it was too late.
Mike, a normal person, was eventually subjected to prefrontal lobectomy because of his severe tendency to hurt people.
So what is prefrontal lobectomy?
You can recall, you've ever heard, what the most brutal surgery was.
In the Czech Republic, sex offenders are chemically castrated, thereby reducing the desires of prisoners. Many plastic surgery hospitals cut off patients' bones to shape them, or even remove their ribs to create a slim body.
But compared to the prefrontal lobectomy below, it is still too pediatric.
At the beginning of the operation, the patient will be firmly tied, and the doctor will insert a cold awl into the patient's eye socket, and then use the hammer to tap a little bit until it pokes into the patient's brain, then just a gentle turn, the sharp awl will crush part of the patient's brain, and 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 of treating mentally ill people, and patients with epilepsy, anxiety, and rage only needed to undergo prefrontal lobectomy and would become sheep to be slaughtered.
Ironically, in 1945, the Portuguese physician Antonio Moniz was awarded the Nobel Prize in Physiology and Medicine.
At that time, if the children did not write homework or were mischievous, then parents would take them to prefrontal lobotomy surgery, and the most popular one was used for those who were mentally ill.
At the end of the movie, Mike, who has undergone prefrontal lobotomy surgery, is completely reduced to a walking corpse that can only drool silly, and the other people affected by him have decided to start a new life.
As depicted in the movie, in real life, the doctors in the major psychiatric hospitals could not distinguish the true identities of several people, and finally with the help of lawyers, several people were successfully discharged.
But not because their identities were discovered, but because several people had disappeared after entering the hospital, they were allowed to be discharged after they were "better".
Therefore, even if they are discharged from the hospital, they are still considered to be relatively stable mental patients.
The results of the experiment had a big impact on Rosenhann.
In 1973, after compiling all the materials, Rosenhann published the experiment in the journal Science.
As expected, the results of the experiment caused an uproar in society as soon as they were announced.
03 The Great Revolution in Medicine
In the article, Rosenhann describes in detail the entire experiment and the attitudes of the doctors in the hospital.
He said that the communication time between doctors and patients every day is not more than 8 minutes, and many times patients will leave before they finish speaking, they are more like completing daily tasks than diagnosing the disease, in the face of the experimenter's active greeting, they will also ignore it and reduce contact with patients as much as possible.
Once, a female nurse unbuttoned her nurse's gown in front of a male patient and straightened her bra in public.
She didn't mean to seduce anyone, but in the eyes of the nurses, she didn't think of these mentally ill people as normal people at all.
The most ironic thing is that although the doctors did not find the true identity of the experimenter, other mental patients were recognized by them.
Once, a mentally ill person approached the experimenter and said to him: "You must be a journalist, or you have come to experience life, in short, you do not belong here." ”
This is not an isolated case, many mentally ill people seem to be able to feel that the experimenter and their difference, and in order to soothe the patient's emotions, the doctor will prescribe some calming drugs to the patient every day.
As a normal person, the experimenter naturally does not eat it, so every time they hide the medicine under their tongues, and then flush it into the toilet when the doctor is not paying attention.
But ironically, they are not the only ones who secretly throw away the drugs, and many patients will secretly throw away the drugs in the toilet, thinking that they are also normal people hiding in the mental hospital.
Because in 1972, during the Vietnam War, in order to avoid enlistment, a large number of American youth would avoid conscription by pretending to be mentally ill.
It's ridiculous and ridiculous that a bunch of normal people are hiding in a mental hospital and the hospital doesn't notice it at all.
Therefore, Rosenhann proposed the "label effect" in the article, he believes that the mental hospital is a special environment, once entered into it, whether you are a normal person or not, will be labeled "mental illness".
Under this label, no matter how normal your behavior is, you will be treated differently and thus identified as a mentally ill person.
Once a person is designatedabnormal, all of his other behaviors and characteristics are colored by that label.
At the same time, Rosenhann also believes that as doctors, they are more inclined to say that a healthy person is sick than a sick person is healthy.
He believes that doctors should use more neutral terms to describe the behavior of patients, rather than having strong emotional overtones and simply thinking that they are sick.
In a decade after the shocking article was published, dozens of Psychiatric-related institutions in the United States collapsed, and the number of mentally ill patients in the United States fell by nearly 50 percent.
Behind the experiment, a more frightening and dark problem was realized, that is, the spiritual identification of criminals.
In the United States, juvenile delinquency is very common, and because the punishment of juveniles is generally not strict under the law, and many juvenile offenders will be identified as suffering from mental illnesses such as depression and split personality, thus obtaining lighter punishments.
Imagine how terrible it would be for a medical institution to correctly distinguish the difference between a mentally ill person and a normal person, and then a heinous criminal could disguise himself as a mentally ill person and thus evade punishment with a false appraisal certificate.
And the U.S. courts are aware of it.
To this end, the American Psychiatric Association has rewritten the diagnostic manual, and they have established new identification standards to compensate for the shortcomings of previous studies.
At the same time, the judgment of psychiatrists has been weakened in the courts of the United States to avoid the use of mental illness by prisoners to escape punishment.
04 Ridiculous secondary experiments
After his article was published, many psychologists expressed strong interest in the experiment, and they came forward to support Rosenhann's conclusions, claiming that they had done similar experiments.
Although Rosenhann's article caused a series of shocks in the American medical community, many people still stood up against his research.
Suzanne, a patient who had been misdiagnosed as a mental patient, questioned Rosenhann's experiments in her best-selling book, The Great Pretender: The Undercover Mission That Changed Our Understanding of Madness.
According to her survey, the subjects of the experiment that year were not eight people, but nine.
Although Rosenhann publicized that he would no longer admit to having symptoms such as auditory hallucinations when they entered the hospital, harry, the ninth person of the year, made up his symptoms in the hospital, which led to a misjudgment by the doctor, and he was hidden by Rosenhann in the data.
Suzanne argues that Rosenhann only chooses strong evidence for her conclusions to support the argument, which is unreasonable.
But despite Suzanne's book selling well, as a journalist, her remarks could not overturn Rosenhann's experimental conclusions.
The most objectionable to the conclusions of Rosenhann's experiments are, of course, the hospitals that he once used as experimental subjects.
After the article was published, the prestige of several hospitals plummeted, patients were taken away by their families, and the hospitals that were originally overcrowded suddenly became empty.
The hospital believed that Rosenhann had deceived the doctors, and they asked Rosenhann to send the experimenter again within three months, this time they would be able to distinguish normal people from patients, and Rosenhann gladly accepted.
So, under the attention of all sectors of society, the new experiment began again, which is a battle for the dignity of traditional Psychiatry in the United States, and all hospitals are gearing up, and it is bound to fight this turnaround battle.
In the time that followed, they exhausted all their knowledge and carefully discerned the strange appearance of the new patient.
Even the slightest trace was keenly discovered by them.
Three months later, several hospitals issued a joint statement that of the 193 new patients admitted in the three months, 41 were disguised as normal people and 42 were suspected patients.
And when they confidently approached Rosenhanne to confront him, Rosenhann only said something lightly.
"I didn't send it alone."