Book Review: "The Great Pretender" by Susannah Cahalan
“The Great Pretender” by Susannah Cahalan
Synopsis: “Doctors have struggled for centuries to define insanity--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 1970s a Stanford psychologist named David Rosenhan and seven other people--sane, healthy, 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 more 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 in this real-life detective story, very little in this saga is exactly as it seems. What really happened behind those closed asylum doors?”—Grand Central Publishing
Rating (out of 5): 4
Review: Shannon and Elizabeth have mercilessly bullied me into joining Book of the Month, and this was my first pick! I was totally absorbed, and I am often loath to read nonfiction. Cahalan’s exploration of the methods to (categorizing) madness, was a deeply fascinating read.
As background, my understanding of the science of psychology is roughly that of Paul Rudd’s in Clueless, “Freshman psych rears its ugly head.” I passed AP Psych with flying colors, but then I proceeded to attend clown college and major in unicorns and rainbows. I had heard of Rosenhan’s famous experiment: pseudopatients attempted to gain admission to mental hospitals using very narrow criteria—stating only that they had been hearing voices saying “empty, hollow, thud.” Other than these troubling symptoms, the pseudopatients were to state that they had no other pressing mental concerns. All were admitted, and all but one were given the diagnosis of schizophrenia. The report that resulted, “On Being Sane in Insane Places,” revolutionized how we diagnose mental illness.
Cahalan explores how Rosenhan’s methodologies and data-keeping can be brought into question. She performed a great deal of research to identify the anonymized pseudopatients, and while she cannot confirm this, suspects that some reports were fabricated. A patient who had a relatively positive experience in his treatment was excluded as well, as his account didn’t align with Rosenhan’s conclusion.
While I generally enjoyed this book and was fully absorbed by it, I found some of Cahalan’s conclusions not entirely convincing, even while I questioned Rosenhan’s tactics. Her own (troubling) experience with psychiatric mistreatment appears to have colored some of her opinions—and how could it not? She concludes a chapter by making broad generalizations about psychiatrists from the psychoanalysis era, stating in closing “If this arrogance is what the DSM-III replaced, good riddance.” It seems like a broad brush to paint with, given that the DSM has caused its own serious problems, to which Cahalan admits.
While I didn’t find the book perfect, it was very well-researched and completely absorbing. I wholeheartedly recommend it, and think it will have very broad appeal.
TL;DR: A nonfiction book about psychology that even non-fiction eschewers will enjoy. Utterly fascinating.
If you liked this, try:
“Nothing to See Here” by Kevin Wilson (Elizabeth’s review here!)
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