The Great Pretender: The Undercover Mission that Changed Our Understanding of Madness
Susannah Cahalan, 2019
Grand Central Publishing
400 pp.
ISBN-13: 9781538715284
Summary
Doctors have struggled for centuries to define insanity—how do you diagnose it, how do you treat it, how do you even know what it is?
In search of an answer, in the 1970s a Stanford psychologist named David Rosenhan and seven other people—sane, healthy, well-adjusted members of society—went undercover into asylums around America to test the legitimacy of psychiatry's labels.
Forced to remain inside until they'd "proven" themselves sane, all eight emerged with alarming diagnoses and even more troubling stories of their treatment.
Rosenhan's watershed study broke open the field of psychiatry, closing down institutions and changing mental health diagnosis forever.
But, as Cahalan's explosive new research shows in this real-life detective story, very little in this saga is exactly as it seems. What really happened behind those closed asylum doors? (From the publisher.)
Author Bio
• Birth—January 30, 1985
• Raised—Summit, New Jersey, USA
• Education—Washington Uiversity
• Currently—lives in Brooklyn, New York City, New York
Susannah Cahalan is the award-winning, New York Times bestselling author of Brain on Fire: My Month of Madness, a memoir about her struggle with a rare autoimmune disease of the brain that affected her at the age of 24.
Cahalan writes for the New York Post. Her work has also been featured in the New York Times, Scientific American Magazine, Glamour, Psychology Today, and other publications. She lives in Brooklyn. (From the publisher.)
Read this account of Cahalan's own illness.
Book Reviews
The Great Pretender reads like a detective story, with Cahalan revealing tantalizing clues at opportune moments so we can experience the thrills of discovery alongside her.… What she unearthed turned out to be far stranger, as documented in her absorbing new book…. [It is the] fraught history of psychiatry and the pursuit of scientific knowledge.
Jennifer Szalai - New York Times
Cahalan's passionate and exhaustive reexamination of the famous research On Being Sane in Insane Places by Stanford psychologist David Rosenhan is a riveting read.… A terrific piece of detective work [with] fascinating insights into the mental health controversies that have swirled ever since the study's publication.
Forbes
This is a well-crafted, gripping narrative that succeeds on many levels. Cahalan, who gained the trust of Rosenhan's family, is meticulous and sensitive in her research; compelling and insightful in her writing.
Financial Times
[A]n impressive feat of investigative journalism--tenaciously conduct, appealingly written... as compelling as a detective novel.
Economist
A stranger-than-fiction thrill ride exposing the loose screws of our broken mental health system.
O Magazine
A thrilling mystery--and a powerful case for a deeper understanding of mental illness.
People
Cahalan's research is dogged and her narrative riveting, leading us from red herring to clue and back with the dexterity of the best mystery novelists. Then she builds her case like a skilled prosecuting attorney.
New York Journal of Books
Cahalan sets a new standard for investigative journalism in this fascinating investigation…. Her impeccable inquiry into the shadowy reality of Rosenhan’s study makes an urgent case that… [psychiatry] must recover the public trust that "Rosenhan helped shatter."
Publishers Weekly
Cahalan's brilliant book… 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. —Lynne Maxwell, West Virginia Univ. Coll. of Law Lib., Morgantown
Library Journal
A sharp reexamination of one of the defining moments in the field of psychiatry.… Her pursuit reads like a well-tempered mystery…. A well-told story fraught with both mystery and real-life aftershocks that set the psychiatric community on its ear.
Kirkus Reviews
Discussion Questions
1. Discuss the book’s title. Does the term "the great pretender" change meaning for you over the course of the book, and if so, how? What different things does it represent to you by the end of the book versus the beginning?
2. In chapter 1, Susannah encounters a woman whose disease was similar to her own, but her fate was drastically different. She begins to refer to her as her "mirror image." How does this figure—and the author’s awareness of her background presence—help shape the rest of the book? What would such a person look like in your own life?
3. Why do you think "On Being Sane in Insane Places" hit such a nerve in American culture in1973, and caused such a sea change in the history of psychiatry? How was it different from the work done by Nellie Bly and other brave pseudo patients and reporters in previous decades?
4. Try to imagine what mental health care in this country would look like now if Rosenhan had never published his work. Would we be in a better place? A worse one? Why?
5. Dr. Levy described Susannah as a ninth pseudo patient. In what ways do you feel that Susannah fills this role in the book?
6. The central mystery of the book propels Susannah down a number of rabbit holes, and to a frustrating series of dead ends, before she discovers the truth. Once she does, she realizes that the answer has been staring her in the face the whole time. How did you feel about this revelation? Have you had any experiences in your own life that have been similarly surprising?
7. From the beginning, psychiatry has struggled with identifying the divide between the body and the mind, between the biological and the psychological, between the "real" and the idea that something is "all in your head." Do you agree that this line needs to be drawn, and if so,where would you draw it and why? Is there a better system of diagnosis than the one we have currently?
8. If you had to write policy for revamping the mental health care system in this country, what would you tackle first? What approach do you feel is the most likely to succeed long term?
9. What was the most exciting, dramatic twist, or piece of evidence, that stuck with you over the course of the book?
10. Susannah describes herself as in awe of Dr. Rosenhan, early in the book, and her drive to understand his study is fueled by her admiration for him; his students frequently describe him as "charismatic" and "charming." But of course, the secrets she uncovers considerably complicate her—and our—portrait of him as a man and a scientist. Have you had any experiences in your own personal or professional life with the fall of a hero, someone you admired who, in one way or another, failed to live up to your expectations? Discuss.
11. If you were Rosenhan’s student and he recruited you to participate as a pseudo patient in the study, would you have done it? Why or why not?
(Questions issued by the publisher.)