
David Rosenhan’s fraudulent Thud experiment set back psychiatry for decades - lcaff
https://www.spectator.co.uk/2020/01/how-david-rosenhans-fraudulent-thud-experiment-set-back-psychiatry-for-decades/
======
Gatsky
Note that Rosenhan was a social psychologist. The list of faulty or outright
fraudulent experiments done by psychologists grows ever longer. The entire
field seems bankrupt to me. Part of the problem are perverse incentives. Get
one positive and interesting result (which you can tailor to the zeitgeist for
maximum impact) and you can live off books, TED talks and lectures for your
whole life. Recent examples include power posing and confidence [1] (poor
experiment) or changing political bias regarding gay rights [2] (outright
fraud).

If psychology wants the status and rewards of being considered a legitimate
science, it needs to make dramatic changes. In the meantime any initial result
psychological research produces must be considered not just preliminary, but
suspect.

[1]
[https://en.m.wikipedia.org/wiki/Power_posing](https://en.m.wikipedia.org/wiki/Power_posing)
[2]
[https://science.sciencemag.org/content/348/6239/1100.2](https://science.sciencemag.org/content/348/6239/1100.2)

~~~
dmix
I can't seem to figure out the incentives behind [2], the idea that during
door-to-door canvassing only gay people can be effective at changing non-gay
people's minds about same-sex marriage seems like an odd narrative for someone
to _want_ to push.

Other than encouraging employment of gay individuals by political
campaigns/canvassers or maybe a general superiority complex, by stating that
only gay people are capable of changing people's minds on the subject.

I have noticed a general pattern on Twitter, from people who push this sort of
social science stuff, that they believe only people who are in the in-group
(ie, race, gender, class, etc) are allowed to have opinions or engage in
research about the group itself. Which always seemed anti-intellectual and
borderline dangerous, as it actively discourages the wider population not only
from doing useful research but also helping overcome ignorance in their day-
to-day conversations, writing books, political projects, etc and generally
engaging in issues.

It just makes everyone even more scared, careful, and closed off to the
subject(s). Which is the opposite incentive structure for 'producing a cascade
of opinion change' (as the study claims).

This just seems to be a punitive approach to change/progress, where oppressed
groups, or people representing the groups, are just in it to collect an
endless amount of things to shame other people for "not getting it", which
ties back into the superiority thing. Assuming the actual goal is ending
oppression, this is taking a totally backwards approach by providing ever more
ways to minimize and degrade the opinions and personhood of other groups. And
when this (self-)destructive strategy is challenged it's met with a bunch of
hand-wavy stuff about privilege to justify everything.

Meanwhile the average person on the outside is just trying to live there life
and aren't heavily invested. This punitive approach, particularly via social
media, would seem to me to make them _more_ likely to just avoid, ignore, or
even resent such talk of change.

~~~
Gatsky
If you are talking about the seeming 'wokeness' of this research well yes,
that is probably a fair comment. But that would be fine if they actually did a
proper experiment. I don't think it is a coincidence that particularly woke
research may be of poor quality. I agree with you that a strong idealogical
bias is a hazard to generating truth. This is most pertinent in preventing
certain types of research from being performed or results from being released.
This is mostly a problem for psychology and sociology, which among their other
merits have limited impact on actual life.

------
hyperpape
While this is fascinating and I'm glad to have read it, it doesn't
substantiate that this experiment set back psychiatry. The fact that the DSM-
IV was prompted or encouraged by the experiment is suggested, but there's no
argument for it. Even beyond that, the article doesn't even hint at an
argument that the DSM-IV set back psychiatry (except offering the bare
assertion that reductionism is false).

Of course, the DSM is very controversial, and many people could fill in the
argument, but this article doesn't do it.

~~~
ttctciyf
Interestingly, the article makes no mention of the followup experiment where
it seems a hospital invited a repetition and then claimed to have found 40 or
so fake patients during the agreed period. Only to be told that the
experimenters had sent none.

Or at least that's the version told in Adam Curtis' documentary _The Trap_
(part 1)[1] which engages in Curtis's usual enthusiasm for fashioning a
sweeping historical narrative out of somewhat sparse materials - in this case
presenting the "Thud" experiment and its followup as a pivot point in the tale
of how R. D. Laing's anti-psychiatry ironically led to the advent of the DSM
IV era.

However that may be, _if_ Curtis' account of the followup is correct it seems
harder to argue the diagnostic prowess of the psychiatrists was not open to
question, regardless of the status of the original experiment.

1: In the section beginning here:
[https://youtu.be/y97Ywl7RtUw?t=2204](https://youtu.be/y97Ywl7RtUw?t=2204)

~~~
77pt77
> Interestingly, the article makes no mention of the followup experiment where
> it seems a hospital invited a repetition and then claimed to have found 40
> or so fake patients during the agreed period.

The reason is simple. This article is pure propaganda along the lines of the
book "The great pretender" by Susannah Cahalan.

The experiment might have flaws, but this second part is conclusive and no
critics ever address it.

This is just another brick on the long propaganda road to a destination that
is very worrisome.

~~~
warbaker
My default position on the follow-up is likewise skepticism. It seems like the
filters at the time were so low that it is likely the follow-up is just a
better constructed lie.

~~~
77pt77
What about the argument, used at the time, that in order for someone to
participate in an experiment like that they had to be mentally ill?

------
perl4ever
The experiment sounds plausible, whether or not it happened or was done
properly. But the claimed response of the hospitals also sounds perfectly
reasonable to me. What do people expect?

A virtually infinite number of things can cause symptoms which have some
overlap with schizophrenia, and that's why today (I'm not an expert, but I'm
assuming what I know of is representative) on intake they classify someone as
"schizophreniform" \- apparently a fancy way to say "looks like/might be
schizophrenia" without committing to anything.

For every person that has a chronic condition, there are going to be many that
have one episode and it never recurs. Maybe it was a virus. Maybe they had
some weird allergic reaction. Hospitals are never going to know for sure
what's wrong with everyone, so the humane thing is not to insist they
determine whether the remainder is "real" or not.

Being involuntarily admitted as a psych patient has permanent consequences,
and it's uncomfortable to think about someone who doesn't "deserve" the stigma
being caught up in it. I think an obsession with this scenario drives the
people who crusade against psychiatry. But putting more pressure on medical
professionals to always get it right is only liable to make things worse. You
can't get better results by applying thumbscrews to people who genuinely try
their best to deal with a fundamentally intractable problem.

This did jump out at me:

"then, as now, no scans, no blood tests, no laboratory findings allowed them
to distinguish the mad from the sane"

In the 21st century, I believe hospitals in the US typically screen for likely
drugs first, when someone appears to have psychotic symptoms. But they also
(at least where I know about) do pretty comprehensive blood tests that show
clear metabolic abnormalities and then just discard the results when they
don't know what it means. So in a sense, sure, there's no blood test for
mental symptoms, and yet if positive tests for various things are routinely
met with a shrug and typical psychotropic drugs administered, then the
statement is misleading.

~~~
Lazare
> But the claimed response of the hospitals also sounds perfectly reasonable
> to me.

Keep in mind, a major part of his paper was about how the pseudo-patients were
admitted after describing extremely limited and mild symptoms. And a major
part of the investigation was determining that, at least in one case, this is
untrue; Rosenhan claimed to have extremely severe symptoms, including suicidal
ideation.

In other words, it now sounds like the hospitals responded reasonably, but
Rosenhan's paper claimed something quite different.

~~~
s1artibartfast
throughout the article I was confused by the term "pseudo-patient". What does
it mean in this context?

Did Roseanhan claim to have a dr-patient relationship with them. Do they just
mean alleged-patients or alleged study subjects?

~~~
Lazare
It's the term he used for the subjects he claimed to have recruited (or for
himself, in one case) who pretended to have symptoms to get admitted.

It's to make the point that he didn't recruit _actual_ patients for the study,
but (in his telling) perfectly sane people to _pretend_ to be ill.

------
droithomme
Hm, the experiment took place before 1973 and involved 8 pseudo-patients, all
anonymous. This person was able to deanonymize and locate 3 of the pseudo-
patients. Because they didn't find all 8 they then claim the study was
fraudulent and never involved 8 people. That seems an absurd conclusion. It's
not reasonable to think one could find all the anonymous/identity cloaked
participants in a nearly 50 year old study.

~~~
warbaker
Given that the researcher was a participant directly, and that he lied about
his actions (he in fact presented suicidal thoughts, etc), I believe the
balance of evidence says we should reject the study.

~~~
droithomme
I agree completely the study is useless and should be withdrawn. But the
author did not prove or even reasonably establish at all that there were 3 and
not 8 participants. Not finding 5 out of 8 anonymous participants in a half
century old study is to be expected. Even decloaking 3 was remarkable. Look at
how hard it is to deanonymize data even now with the computational power,
combined with endemic surveillance and monitoring of the public. It's totally
unreasonable to conclude the other 5 didn't exist.

Even without the anecdotal information that things were not presented as they
were told, the study is still, and always has been, useless. If someone
presents at an asylum begging to be admitted, and describing strange symptoms
that they say are causing them distress, it is reasonable to admit them for
observation.

------
dredmorbius
Thoughts:

The problem of false priors, deliberate misdirection, and motivated reasoning
are insidious. Having to un-learn false models is difficult and expensive,
personally, bit especially socially.

Even if Rosenhan's experiment was a fraud, the notion that psychiatric
institutions or the field of psychology _does not_ engage in the practice of
arbitrary, thinly-supported, or entirely fictitious diagnosis, or failure to
account for changes in condition, _at least at times_ isn't disproved. And ...
at least to my lay understanding ... this does seem to manifest elsewhere than
in Rosenhan's accounts.

There are two competing sets of motivated reasoning to be considered here,
which makes determination of ground truth that much more difficult.

On false priors, I've been familiar for a time with the notion of
"Wittgenstein's Ladder", a/k/a "Lies told to children"
([https://en.wikipedia.org/wiki/Wittgenstein%27s_ladder](https://en.wikipedia.org/wiki/Wittgenstein%27s_ladder)):

 _My propositions serve as elucidations in the following way: anyone who
understands me eventually recognizes them as nonsensical, when he has used
them—as steps—to climb beyond them. (He must, so to speak, throw away the
ladder after he has climbed up it.)_

 _He must transcend these propositions, and then he will see the world
aright._

\-- _Tractatus Logico-Philosophicus_ 6.54

This leads to the challenge over time of finding oneself having climbed the
ladder, but in discussions with others, constantly confronted with it, and
having to explain around or over it. Wittgenstein's Ladder becomes, when
erected horizontally across a passage of understanding rather than vertically
to greater heights or across gulfs, Wittgenstein's Barricade.

It's this constant having-to-retread-fundamentals which seems to actively
impede further development of knowledge and understanding, and which I've
found increasingly intolerable in much popular media and discussion. Worse
when it's not even the fundamentals which are being retread, but someone's
self-serving current reformulation (often worse than the original). See
Schopenhauer's "On Authorship".

------
jeffdavis
Perhaps more disturbing than getting a mental illness diagnosis (correct or
not) is that there is no scientific way to prove that you are cured.

~~~
s1artibartfast
The only think I find more terrifying than a mental illness misdiagnosis, is a
misdiagnosis with forced incarceration.

Assuming Rosenhan's study was fictional, what was his intent? Was it a lie
intentionally designed to discredit, destroy, or reform these institutions?

~~~
jeffdavis
Forced incarceration is pretty rare, and doesn't seem likely to become common
or misused in severe ways.

I'm more worried about a diagnosis -- even a correct one -- that marks you
forever and limits your freedom in overt and subtle ways.

I'm sure that prevents a lot of people from seeking treatment, unfortunately.

~~~
sysbin
> Forced incarceration is pretty rare, and doesn't seem likely to become
> common or misused in severe ways.

How do you know if it's pretty rare? I'm unaware of anyway for people to
collect data on it. I'm doubtful anyone can get justice when it happens,
unless insanely rich and or large media following while being wrongly forcibly
incarnated.

I'm not aware of many limitations besides some people getting their driver's
license taken away. I think most people don't seek treatment because they
don't really believe in the psych illnesses. Also the baggage that comes with
relying on medication with the short or long term side effects.

~~~
77pt77
> I'm not aware of many limitations besides some people getting their driver's
> license taken away.

Forget ever legally owning a gun. Or get a security clearance. And if you ever
end up in court it'll almost immediately disqualify your testimony.

------
andrewfromx
wikipedia link to get summary
[https://en.wikipedia.org/wiki/Rosenhan_experiment](https://en.wikipedia.org/wiki/Rosenhan_experiment)

------
CriticalCathed
This is the first time I'm hearing that it was a hoax from the start. I've
heard this study referenced more times than I can count in discussions on
mental illness and mental hospitals. Could it really be that it was complete
horseshit?

~~~
crazygringo
The article says the book only suggests it _could_ have been fiction, in that
no records exist that allow people's participation to be verified.

It's still entirely possible that it happened as reported, but that the
(properly) confidential records were destroyed/lost.

According to Wikipedia, "'[s]he writes that she cannot be completely certain
that Rosenhan cheated', despite entitling her book as she did." [1]

[1]
[https://en.wikipedia.org/wiki/Rosenhan_experiment](https://en.wikipedia.org/wiki/Rosenhan_experiment)

~~~
thaumasiotes
> It's still entirely possible that it happened as reported, but that the
> (properly) confidential records were destroyed/lost.

Did you read the article? This isn't possible at all.

> the distinguished psychologist Eleanor Maccoby, who was in charge of
> assessing Rosenhan’s tenure file, reported that she and others were deeply
> suspicious of him, and that they found it ‘impossible to know what he had
> really done, or if he had done it’, granting him tenure only because of his
> popularity

True, this is just circumstantial.

> At various times, Rosenhan had proffered sometimes contradictory
> biographical fragments about pseudo-patients 2 through to 8, but even with
> the assistance of a private detective, these leads led nowhere.

Hmm, it'd be hard for everything to have happened as reported, given that what
was reported contradicted itself.

> In a larger sense, it scarcely matters, because Cahalan uncovered so much
> other evidence of Rosenhan’s malfeasance and lies.

Hmmmmmmmm...

> He claimed, for example, to have carefully coached his volunteers before
> sending them forth. Bill Underwood and Harry Lando emphatically denied this.

OK, now we know it didn't happen as reported even in cases where there wasn't
an internal contradiction in the reporting.

> Lando appears to have been dismissed from the study, not because he violated
> protocol, but because, as Rosenhan incredulously noted about his
> confinement, ‘HE LIKES IT!’

The "throw away any data you don't like" school of research.

> Most damning of all, though, are Rosenhan’s own medical records. When he was
> admitted to the hospital, it was not because he simply claimed to be hearing
> voices but was otherwise ‘normal’.

Note that this is what he reported he had claimed.

> On the contrary, he told his psychiatrist his auditory hallucinations
> included the interception of radio signals and listening in to other
> people’s thoughts. He had tried to keep these out by putting copper over his
> ears, and sought admission to the hospital because it was ‘better insulated
> there’. For months, he reported he had been unable to work or sleep,
> financial difficulties had mounted and he had contemplated suicide. His
> speech was retarded, he grimaced and twitched, and told several staff that
> the world would be better off without him.

~~~
tempestn
Not sure why you're being down voted. Maybe just tone with the 'hmmmmm' and
such. Anyway, I agree that there appears to be ample evidence for this
conclusion.

~~~
unishark
wasn't me who downvoted, but my guess is it's because of the guideline against
commenting on whether someone read the article.

~~~
tempestn
Ah, yes, I missed that.

------
imperio59
The fact is psychiatry today still lacks tests or any proof of its claims of
"chemical imbalance", which remains unproven. No one had established a profile
for what a "balanced brain chemistry"looks like, nor do they test for any
brain chemistry imbalance.

Diagnosis is still left to the subjective assessment of the practitioner
before prescribing powerful psychotropics that DO change brain chemistry in
unpredictable ways, and cause a host of side effects often worse than the
original symptoms.

So the argument today that psychiatry lacks any scientific basis and rigor for
its practices is still very valid and legitimate.

~~~
Angostura
This seems overly pessimistic to me, there are drugs that significantly
improve patients wellbeing and do so consistently and repeatably, despite the
fact that we don't have a complete understanding of the complete mechanism of
action.

If I do a study showing that handwashing in surgeons measurably reduces risk
of infection, does the fact that I don't know about microbes make lacking in
scientific rigor and remove its scientific basis?

~~~
phkahler
>> there are drugs that significantly improve patients wellbeing and do so
consistently and repeatably,

No, there are not. A given drug may work consistently for some people, while
having no effect, or detrimental effects on other people with the same
diagnosis.

~~~
JohnBooty
Either you misunderstand or you're being disingenuous here.

"Consistently and repeatedly" does not mean "this works 100.0% of the time."

Would you deny that exercise fails to consistently and repeatably help people
lose weight? Would you say that existing treatments for heart attack victims
fail to consistently and repeatably help victims? Would you say umbrellas fail
to consistently and repeatably stop rain from falling on your head?

None of these things work 100% of the time, but they are frequently
successful.

Psychiatry is a field still in its infancy due to the difficulty of studying
the mind. We should hold it accountable for its failings and work to make sure
it improves. But, it has successes as well.

It's not the only game in town when it comes to mental health, for sure, but
it's also compatible with a lot of other things that can have great benefits
for mental health. Meditation, lifestyle changes, exercise, therapy,
environment... none are incompatible with psychiatry, which is not perfect but
can be a valuable tool in the toolbox.

------
deanmen
Article without paywall
[https://pastebin.com/gDBDdTB6](https://pastebin.com/gDBDdTB6)

------
aaron695
> set back psychiatry for decades

Milgram, ‎Zimbardo all these experiments from the 50's onwards are junk.
Doesn't mean it set back psychiatry.

How psychiatry works is you get something that you intuitively think is true,
make up a experiment to prove it (so it's ok for others to agree without
getting in trouble)

Then consensuses decides.

It's blockchain.

