Stuck in Insanity

You trust your doctor don’t you?  Generally, if you’re feeling sick, or even if you just have a little cold, you go to your doctor to see what is wrong.  We assume that everything can somehow be fixed medically.  If you thought someone was mentally ill, sending them to a psychiatrist most likely seems like the best option. We assign medication to practically anything that we can dub as “illness.”

Well, back in 1973, David tumblr_mccuokqmNo1qjsbyqRosenhan conducted an experiment on himself and seven other people to completely deny the concept of medical diagnosis.  Although, we may see a psychiatrist on the same level as a doctor, Rosenhan sought to prove otherwise.  Rosenhan poses the intriguing question, “If sanity and insanity exist, how shall we know them?”  Simply by just asking this question, he completely disregards the idea of medical diagnosis for mental illness.  Rosenhan’s theory is that mental illness is something that is superimposed by one’s environment.

There is a play called Menaechmi about twin brothers who get separated at age seven.  The brother who was born first was named Menaechmus and the second was named Sosicles.  However, after Menaechmus was kidnapped when the two boys were both seven, the parents renamed Sosicles to Menaechmus in honor of his beloved brother.  In the performance of this play, Sosicles goes on a long search to find his lost brother, but while he is in his brother’s hometown, everyone mistakes Sosicles as his twin brother.  Also, since he is now called Menaechmus, everyone is calling him by his name even though he does not know them and it utterly confuses him.  Sosicles has no idea how these people could possibly know him.  He doesn’t understand how they could know his name either.  This makes the entire play hysterical.

As Sosicles continues his impending search for his brother, he keeps on running into people that know his twin brother and mistake him for him.  There is one part of the play where Sosicles meets a prostitute and has lunch at her house.  Then to his surprise, she offers herself to him.  However, as he is departing the courtesan, he runs into his twin brother’s wife, just outside the house.  She is furious and Sosicles has no idea who this lady is.  She calls her father over to the scene to take action against him.  Sosicles is so confused.  He has no idea who these people are or how they know his name.  All of a sudden Sosicles understands what is going on and he decides to pretend to be mentally insane in order to get these people to leave him alone and it works.

Sosicles pretends that he is hearing voices.  The voices tell him to act out in violence.  The woman’s father is startled and declares Sosicles as mentally ill.  The woman’s father automatically connects Sosicles’ insanity to illness and runs off in search of a psychiatrist.  Although the psychiatrist has not met him yet, the psychiatrist automatically assumes that he is ill and in need of great help.  The psychiatrist has no doubt that they can make Sosicles sane again.  Meanwhile, Sosicles’ twin brother is just getting home from an awful day at work as a lawyer.  Menaechmus is ranting about his day while the psychiatrist and his father in law are listening.  Then after listening to Menaechmus rant for a while about his day, they rush over to him and the psychiatrist introduces himself to Menaechmus.  The psychiatrist prods him with many questions and it begins to really piss off Menaechmus.  Yet the psychiatrist is completely unfazed and still believes that they can help poor ill Menaechmus.  The psychiatrist prescribes him a drink called hellebore, in order to “cure” him, although he is not even sick.  Menaechmus is just really pissed off and his anger is being seen as insanity.

Now, an experiment conducted by a man named David Rosenhan in 1972 was alarmingly similar to this performance of Menaechmi.  In this experiment Rosenhan and 7 other people each pretended to have a mental illness in order to get into 12 different mental institutions.  Each person pretended to be having auditory hallucinations and they were pretending to hear the words empty, dull, and thud.  After admission, hospitalization ranged from seven to 52 days, with the average stay being about 19 days.  After admission, the patients immediately started acting normal again.  Beside using fake names and pretended to have fake jobs, they were consistent with every other detail of their lives.  Their account of their personal relationships and their history stayed accurate.  After each posing patient was eventually released, they each were diagnosed with “schizophrenia in remission.”  Even after they started acting normal again, the label of “schizophrenia” was never disregarded, but rather upheld even after their schizophrenia appeared to be in remission.

The experiment is so similar to the play Menaechmi.  In both the play and the experiment mental illness was being faked.  Both Sosicles and the people who posed as mentally ill patients were pretending to hear voices and this made them automatically appear as insane.  Once the posing patients were admitted into their institutions they dropped the act of insanity and in the play of the twin brothers, soon after Sosicles was diagnosed as insane, the psychiatrist ran into his twin who had no idea why this psychiatrist was prodding him with questions.  This represents how the posing patients dropped their act of insanity immediately after admittance.  In both the play and the experiment, after being clinically diagnosed, the act of insanity was dropped.  However, the psychiatrists’ label was never forgotten, even after the patients were released.  The characters in the play misattributed confusion for insanity and some characters in the play believe that insanity is something that resides in the brain.  Both the characters in the play and the psychiatrists in the experiment automatically assume that the patients are mentally ill.  However, we cannot blame the psychiatrist for the “diagnostic leap,” because once a patient is under the psychiatrist’s care, it is their job to diagnose the illness.  However, if it is so easy for one to pretend to be insane, how many people are actually insane but are not recognized as so by our mental institutions because diagnosis is not being conducted properly?

I believe we use simple-single phrases to diagnose patients so that we feel like there is a cure, or an answer to the supposed problem.  However, if behaviors that are simply stimulated by the environment are diagnosed as mental illness, this misattribution to disorder cannot be relieved through medication.  In fact, labeling may be trapping patients into believing they are insane. trap Through Rosenhan’s experiment, it has become obvious that simple diagnosis is not the answer.  Especially because the mental hospital’s environment superimposes the context of insanity on its patients, with each doctor automatically assuming that each patient is mentally ill.  Naming an illness creates for us a sense of simplicity for the complication we encounter.  It helps us believe that the illness, or complication, is manageable and can eventually be overcome.  However, Rosenhan’s experiment showed that this type of diagnoses lacks validity and therefore, so does the treatment.  Also, if someone’s environment is treating them insane, how much more will that make them feel insane, and if they already are, how much more will it stimulate their insanity?  Rosenhan’s argument amounts to the idea that medication is not the answer to an illness if it does not exist within, but is being imposed and is created by one’s environment.  So the real question is, “Are institutions actually trapping the people who have been labeled mentally insane?”