On Being Sane In Insane Places Analysis

American psychologist, D. L. Rosenhan wrote “On Being Sane in Insane Places” based on his findings from an experiment he conducted within psychiatric facilities. Rosenhan was interested in finding how credible these facilities are with how they diagnose patients. The experiment consisted of eight pseudopatients of different backgrounds who were admitted into twelve hospitals in five differents states across the country. Each of the pseudopatients set up an appointment claiming to have been hearing voices saying “empty,” “hollow, and “thud” (Rosenhan 251). Once admitted into the hospital’s psychiatric facility, the pseudopatients took detailed notes of their experience and how the staff interacted with the patients. With the hospitals not having

any knowledge of the pseudopatients’ real intentions or their sanity, the hospitals all failed to detect the presence of the noticeably sane patients they had residing in their facility.
A second experiment was conducted when research hospitals heard of the errors that took place by the hospitals in the first experiment. Staff was informed of possible pseudopatients being admitted and were asked to find who was most likely not an actual psych patient. Forty-one out of one hundred and ninety-three patients were suspected to be pseudopatients, however not one pseudopatient (from the original experiment) was seeking admittance, This second experiment proves that when the hospital is at risk for losing its credibility it will over compensate to maintain its platform. This also proves that the type two error used in the medical diagnostic process does not work in the psychiatric diagnostic process.
Rosenhan wrote this article to bring attention to the issues that take place in the modern day psychological facilities. He uses rhetorical appeals to grab the reader’s attention in order for more people to hear his concerns and look closer to the evidence he pulled together and find a way to change the current problems taking place. Rosenhan uses logical appeals, logos, to show the evidence of this experiment and to prove his opinion on the matter. He uses ethical appeals, ethos, to question the ethics and credibility of the facilities used in the experiment. Lastly, he uses emotional appeals, pathos, to give the patients a voice and get the reader to empathize with what the patients feel. By putting all of these rhetorical appeals together in one article, Rosenhan wrote a piece that makes the reader want the world of psychiatric medicine to find a better way to diagnose patients without leaving them with a stigma that is attached to them for the rest of their lives.
Logos is the logical evidence used in the piece to give the reader information about the experiments. The pseudopatients had all agreed to the terms of the experiment, knowing that they would be fully admitted into the hospital as a real psychiatric patient, with that they realized they would have to figure out how to get themselves out of the hospital. “The pseudopatient entered a hospital with no foreknowledge of when he would be discharged. Each was told that he would have to get out by his own devices, essentially by convincing the staff that he was sane” (Rosenhan 252). The pseudopatients were all admitted into the hospital for different amounts of time. They all managed to get themselves out of the hospital, however it was not by proving their sanity. “Despite their public ‘show’ of sanity, the pseudopatients were never detected” (Rosenhan 252). These eight people were admitted into a psychiatric hospital with the assumption that they were schizophrenic, but when they entered the hospital they no longer showed the symptoms they initially told the administration they were experiencing. Instead of the hospital determining that the patient was in fact never a schizophrenic, they were discharged as “in remission” (Rosenhan 252). The pseudopatients acting as “normally” as they did in the outside world, however they were never detected to be any different from the insane. According to the evidence from the experiment the staff did not spend very much time interacting with the patients, unless it was for a required amount of time. “On average, daytime nurses emerged from the cage 11.5 times per shift... Late afternoon and night nurses were even less available, emerging on the average 9.4 times per shift” (Rosenhan 254).
This logical evidence can also lead to the ethical questioning, ethos, of the facilities in the experiment. The staff at the hospitals kept their distance from the patients unless it was completely necessary to interact with them. “Otherwise, staff keep to themselves, almost as if the disorder that afflicts their charges is somehow catching” (Rosenhan 254). The way the staff acted was as if they too would become “insane” if they were around them more than necessary. Not only did the staff avoid the patients, in some cases if the patient irritated the staff member in any way they would abuse the patients without later questioning on the behavior. “I have records of patients who were beaten by staff for the sin of having initiated verbal contact… Nevertheless, they often appeared to go unquestioned. Tempers were often short” (Rosenhan 256). Staff could get away with beating patients because they did not want to interact with them, and it would go unquestioned due to the fact that the clinically insane are seen as less than human in their eyes and perhaps the eyes of society itself. In some cases, patients were not only beaten, they were also forgotten about and seemed invisible. “A nurse unbuttoned her uniform to adjust her brassiere in the presence of an entire ward of viewing men. One did not have the sense that she was being seductive. Rather, she didn’t notice us” (Rosenhan 256). The real patients that are put into these facilities are treated so badly or they are so unnoticed that you wonder how could these hospitals ever be able to tell if that person is truly insane? These ethically questioning behaviors that are so normalized in a psychological facilities staff are so demeaning that it plays into how the patients must feel while spending their time within these places.
Rosenhan uses pathos, emotional appeals, to help the reader get a sense of how it must feel to be a patient within one of these facilities and their lives after being discharged.

He talks about how even after the pseudopatients are discharged they are still considered schizophrenic, there condition is just considered “in remission.” “Rather, the evidence is strong that, once labeled schizophrenic, the pseudopatient was stuck with that label… he was not sane, nor, in the institution’s view, had he ever been sane” (Rosenhan 252). Based on the institution’s views on their patients, someone who was once considered mentally ill would always be considered just that. There is no changing the status of a once insane person despite whatever it was that ailed him. Unlike with traditional medicine, there is no way to heal from mental illness. “A broken leg is something one recovers from, but mental illness endures forever” (Rosenhan 253). A person that spent time in a psychological institution will have this status on his record, causing potential problems in his future career or personal life. Rosenhan has such an importance for emotional appeals that he even titles a section “Powerlessness and Depersonalization” (Rosenhan 255). He talks about even as pseudopatients they felt as if they did not exist within the facility. “At times, depersonalization reached such proportions that pseudopatients had the sense that they were invisible, or at least unworthy of account” (Rosenhan 256). If even a pseudopatient, being someone who is not really clinically insane, can feel these kinds of emotions from being admitted to these hospitals, how can we possibly come to understand the emotions a reasonably diagnosed patient feels? This leads us to the question that Rosenhan himself asked in his article. “How many have been stigmatized by well-intentioned, but nevertheless erroneous diagnoses” (Rosenhan 257)? The people that are potentially misdiagnosed with a mental illness have no way of

erasing that label from their life. How are we to know how many people have been misdiagnosed by psychological medicine because they do not take the time to discover if the patient is truly sick?
Rosenhan wrote an article on his findings from an experiment he created to find how credible the psychological facilities in America truly are. His evidence proves that these modern day facilities are inadequate with their diagnoses and need to find new ways to determine who is truly mentally ill. Unlike in traditional medicine, mental illness endures for a lifetime whether or not that person is truly sick or not. Psychological medical institutions need to discover ways to diagnose the mentally ill and rehabilitate them in such a way that they no longer have to live with a crippling stigma for the rest of their life within today’s society.