On being sane in insane places.

Traditional psychiatric criteria for a person being sane or insane is the “level of one adaptation to reality”. Criteria assumes existence of real, objective reality and that such a reality is open to our critical observation and understanding.
In 1973, a psychologist David Rosenhan published a paper in a respected magazine Science, called “On Being Sane In Insane Places. It had an effect of a scientific bomb, because it demonstrated that some psychiatric diagnosis didn’t exactly define, but create pathological state. Once you have been diagnosed with something, the reality is turned upside down in a way that normal behavior is seen as abnormal. From that moment on, an incontrollable force creates a new reality with the patient and everybody around the patient. Diagnosis creates a pathological state and that state create the need for institutions that provide treatment. The surrounding of the institution creates helplessness and depersonalization of the patient and that, in turn, confirms “the rightfulness” of the diagnosis. The outcome is a self-fulfilling prophecy that with time, even the patient accepts as realistic and adjust his life accordingly.
Rosenhan and his associates briefly feigned auditory hallucinations in order to get admitted in one of 12 psychiatric hospitals. After being admitted, the false patients behaved normal and claimed not to have any more hallucinations. But, every patient but one was diagnosed with schizophrenia (that one being diagnosed with bipolar disorder). On average, they spent 19 days in hospital. As a condition of their release, they had to agree on being mentally ill and accept being medicated.
In the second part of the study, one institution challenged Rosenhan to send false patients there, claiming their staff will recognize them. Almost one in four new patients was recognized as possible false patient and 10% of patients were considered to be false patients by at least two members of the staff. Rosenhan, in fact, didn’t send a single false patient.
These findings can be applied to many self-fulfilling prophecies that rule our lives. We label people around us (ourselves included) every day, and those labels are called diagnoses in medical context. Then, we expect them to behave in line with those labels, we created for them ourselves, and that don’t exist as objective reality. Furthermore, we are especially sensitive to the clues from the surroundings that confirm beliefs we created. In the same time, we tend to disregard clues that are not in line with our beliefs.
The is no “objective reality” around us, that is to be perceived the same by everyone, regardless of a person perceiving. We all create our own reality, that is far from objective and we have to be aware of that when we label people (again, ourselves included). In every moment, there are many different realities and different labels. And our perception is what creates them our own reality.