The Great Pretender: The Undercover Mission That Changed Our Understanding of Madness

Employing her journalistic research skills and intensely personal experience with misdiagnosis and the psychiatric profession, Cahalan (Brain on Fire: My Month of Madness) investigates legendary psychological researcher David Rosenhan. Psychology students will immediately recognize Rosenhan as the author of the seminal study “On Being Sane in Insane Places,” an experiment in which mentally sound investigators infiltrated psychiatric hospitals by feigning symptoms suggestive of schizophrenia. Rosenhan hypothesized that psychiatric diagnosis was so imprecise that doctors could not readily differentiate the sane from the insane. Thus, while undercover investigators easily gained admission to hospitals, it was extremely challenging to get released, despite their behaving normally. Rosenhan’s study helped revamp our entire mental health system, resulting in the mass closure of hospitals. But was Rosenhan correct? This is the fundamental question explored in Cahalan’s brilliant book, in which she diligently traces and interviews people associated with the study, the circumstances of which became increasingly suspect. In the end, she provides a convincing argument that Rosenhan largely fabricated his research.