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Can you be judged sane in an insane place

#41: Nov. - Dec. 2007 (Non-Fiction)
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jales4
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Can you be judged sane in an insane place

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Page 322 tells the story of a group who lied about symptoms of mental instability and were committed to mental hospitals. Once inside, they exhibitied sane behavior at all times. It took them several weeks, with the help of colleagues and lawyers, to be released.

This story seemed to be completely at odds with everything Zimbardo has said about situational influences.

These individuals were in an insane asylum for weeks, surrounded by insane people, treated by staff as though they were insane, etc., and they still managed to behave 'sanely'.

Given what we have learned about situational influences, I would have thought some of them would have suffered breakdowns, etc.

Does this seem like a contradiction to anyone else?
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I don't see a contradiction, for two reasons. From what I've read, being a patient in a mental institution can make people feel a little crazy. On the other hand, mental hospitals do sometimes cure people, implying that their institutional pressures can make patients more sane.
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I n
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Aubrey.Alexis
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I am also concerned by this issue - but rather, there seemed to be a bit of mistrust by the guards for the prisoners who were the most sane. I mean, some of the subjects of the experiment were not extremely influenced by the situation. Human beings are extremely adaptable, and to what extent is it insanity to hold onto your previous idea of sanity when all of the factors in your setting have changed?

Would the guards and prisoners have experienced less stress and other negative symptoms if they had changed their reactions and dealings with the world - altered their "sanity" a bit?
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I think that one o f the points that we need to appreciate about experiments like these is that the smallest of details and primes can affect the outcome in large ways.

Take for instance, in the SPE, one of the prisoners said that they could not leave, and everybody accepted this, in spite of the fact that it contradicted their contracts. Imagine how differently the experiment would have turned out if the group had not accepted this or if Zimbardo had made a point of contradicting the prisoner! (In fact I think that this was one of Zimbardo's failings. If you're running an experiment that could harm a participant and it becomes clear during the course of the experiment that the participants is not aware of their rights, you need to step in and correct them). Similarly, read the section on page 315 entitled Just Ask For It.

The difference between the two psych ward scenarios was that it was only in one of them that people assumed the role of patient. In the second mentioned experiment, the participants know that they are supposed to be 'normal' people and should act like so. They have a script or schema from which to act.
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"On being sane in insane places"

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At the end of chapter 13, Zimbardo refers to David Rosenhan 's experiment "On being sane in insane places".

It is a short reference, and I think it is important to note that the study dates back to 1973. It seems to be quite a famous experiment judging from the number of answers from Google. I think one needs more information than is given by Zimbardo. There is a complete description on the net (see below).


The findings of the 1973 experiment are quite frightening, and to some extent confirm some of the things I suspected about psychiatric hospitals, but in a much worse version.

You might say p h were not really Zimbardo's point, but I'll carry on all the same, my question being what might happen if one tried out such an experiment in 2008.

First, psychiatry has evolved a lot. They know much more about schizophrenia for example than they did in the 70's, so one would have to imagine a different pathology/diagnosis.

Then, with the shortage of hospital beds everywhere, and also I imagine less willingness to hospitalize patients, you would have to come up with something more convincing than "hearing voices" to be admitted.

Next, the would-be patients in the experiment, once admitted, were apparently all allowed not to take their medicine. Nowadays, as far as I know, the chief duty of nurses in psychiatric hospitals is to make sure that all patients take their medicine, in front of the nurse. Refusal to do so has immediate consequences. I saw a short report about this on TV a few months ago. The nurse was a pleasant young man, and when one of the patients refused to take her medicine, he tried to convince her, and reminded her that in this case, he would have to call the doctor , and he told the journalist that this meant an injection.
The psychiatric ward did not look like a ferocious place, just rather sad, like some elderly people's Homes for example.
Once the drugs had been taken... they are not meant to knock you out, but they are powerful and would certainly slow you down, perhaps make you sleep.
Then, psychiatry is not an exact science, and a very important element in diagnosis is.. how you react to treatment!

Next, the part that may still sometimes be true nowadays is that some things might not be diagnosed because hospitals are short of staff and the people who make the decisions may not have enough time to talk to the patient for very long.

Finally, in psychiatric hospitals in France , if the patient asked for admittance on his own accord (as opposed to being brought by the police or his family for example, or sent by his psychiatrist in an emergency) he is legally entitled to leave and, unless he behaves violently or is obviously suicidal, I imagine he would be allowed to leave if he asked (bearing in mind they are short of beds, etc..) and showed willingness to take part in a programme by making an appointment for follow-up with a psychiatrist.

In conclusion, I think any (sane...) citizen would be well advised to think about how to obtain a minimum of information about psychiatric hospitals in their country. If your first encounter with the world of psychiatric hospitals happens when a relative or a friend ( I won't suggest the relation could be any closer) is abruptly admitted in one, the experience can be quite traumatic.

Contrary to other medical conditions, information about this is hard to come by, as nothing much seems to filter out.

I recommend the following link to Rosenhan's published paper (to be found on Julian's posting below: thanks, Julian).
Last edited by Ophelia on Sat Jan 05, 2008 4:46 pm, edited 2 times in total.
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Ophelia's link didn't work for me.

The Wikipedia article about the Rosenhan experiment presents a clear overview:
http://en.wikipedia.org/wiki/Rosenhan_experiment

It mentions this amusing tidbit:
During their stay, hospital notes indicated that staff interpreted much of the pseudopatient's behaviour in terms of mental illness. For example, one observer, apparently oblivious to the irony, labeled the note-taking of one pseudopatient as "writing behaviour" and considered it pathological.
For more details, you can read Rosenhan's published paper:
http://www.stanford.edu/~kocabas/onbeingsane.pdf
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