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

I was so excited to read this book because I loved her first book, BRAIN ON FIRE, which was her own journalism-style memoir chronicling her experience with autoimmune encephalitis that manifested itself with symptoms similar to schizophrenia. Had she been misdiagnosed, she could have ended up with permanent brain damage-- or dead. Given that close call, it's understandable that the author might have some skepticism about psychology. A lot of people do, and like a lot of sciences, its beginnings seem backwards and barbaric. Of course, since psychology is one of the newer sciences, those beginnings are far more recent than most.

THE GREAT PRETENDER is about the Rosenhan experiment, a study in which volunteers (including the psychologist leading it) pretended to have vague symptoms and see if they would get checked in to a mental health facility. Spoiler: according to the researcher's notes, all of them did, and all of them (except for one) ended up with diagnoses of schizophrenia (the other was diagnosed as borderline, I think, or manic). Also spoiler: they found the conditions pretty horrible, too. Staff were unsympathetic and liable to treat even normal behaviors (such as journaling) as mentally ill.

Cahalan manages to get access to the psychologist's notes and even interview some of the participants in the study. Her findings, through supplementary research and some historical context, are pretty grim on both sides. Yes, clinical psychologists have, historically, done some pretty awful things in the name of medical science, whether it's treating patients like circus acts (19th century Bedlam) or doing gratuitous surgeries assembly-line style, to those who are willing and not (lobotomies). Cahalan talks about a Victorian journalist who checked herself in to a psychiatric facility and was horrified by the results. Rosenhan and his experimenters, while finding themselves in conditions nowhere near as horrifying, were still shocked at their cold and impartial (and sometimes unhygienic) treatment.

When the study came out, people immediately sought to riposte it. Psychology is an oft-villainized field and I think there was probably a concern that a distrust in the industry might dissuade people from seeking the treatment they might need. Less philanthropically, I'm sure they were also concerned for their careers and the cash money said careers brought in. As Cahalan notes, the study may not have been as truthful as it could have been, as there were some factual disputes that arose when his data was cross-referenced with interviewees and other sources.

I wanted to like this book a lot more than I did, being that I was a psychology major in school and actually contributed to active research studies. Supposedly, there's even one floating around out there with my name on it. Initially, I was very interested in the subject of the experiment, but it quickly wore thin as it was much drier than I was expecting and the whole time I was reading, I kept comparing THE GREAT PRETENDER unfavorably to the author's first book. I do think if you want to read a book that goes into depth about what psychiatric clinics are like, as well as the ethics of psychology and treatment, you might enjoy it, but those who aren't interested in psychology and have only scant interest in the topic will be disappointed, as this is hardly titillating and textbook-dry.

Thanks to the publisher for sending me a copy in exchange for an honest review!  

2 to 2.5 out of 5 stars