Summary and book reviews of The Great Pretender by Susannah Cahalan

The Great Pretender

The Undercover Mission That Changed Our Understanding of Madness

by Susannah Cahalan

The Great Pretender by Susannah Cahalan X
The Great Pretender by Susannah Cahalan
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     Not Yet Rated
  • First Published:
    Nov 2019, 400 pages
    Paperback:
    Jul 2020, 400 pages

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Book Reviewed by:
Elisabeth Herschbach
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About this Book

Book Summary

From "one of America's most courageous young journalists" (NPR) and the author of the blockbuster #1 New York Times bestselling memoir Brain on Fire comes a propulsive narrative history investigating the 50-year-old mystery behind a dramatic experiment that changed the course of modern medicine.

For centuries, doctors have struggled to define mental illness--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, normal, 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, very little in this saga is exactly as it seems. What really happened behind those closed asylum doors, and what does it mean for our understanding of mental illness today?

1
MIRROR IMAGE

Psychiatry, as a distinct branch of medicine, has come far in its short life span. The field has rejected the shameful practices of the recent past—the lobotomies, forced sterilizations, human warehousing. Today's psychiatrists boast a varied arsenal of effective drugs and have largely dropped the unscientific trappings of psychoanalytic psychobabble, the "schizophrenogenic" or "refrigerator" mothers of yesteryear who had been blamed for triggering insanity in their offspring. Two decades into the twenty- first century, psychiatry now recognizes that serious mental illnesses are legitimate brain disorders.

Despite all these advancements, however, the field lags behind the rest of medicine. Most of our major innovations—better drugs, improved therapies—were in play around the time we first walked on the moon. Though the American Psychiatric Association reassures us that psychiatrists are uniquely qualified to "assess both the mental and physical aspects ...

Please be aware that this discussion guide may contain spoilers!
  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 in 1973, and caused such a sea change in the history of psychiatry? How was it different from ...
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Reviews

BookBrowse Review

BookBrowse

Susannah Cahalan's The Great Pretender is a fascinating deep-dive into one of the most influential studies in the history of psychology, Stanford University professor David Rosenhan's 1973 paper "On Being Sane in Insane Places." But while the extent of Rosenhan's influence on the field is clear, it turns out that little else about his story is straightforward. As the book unfolds, it becomes evident that there is yet another layer of meaning to its title—neither Rosenhan nor the details of his study are quite what they appear to be...continued

Full Review Members Only (962 words).

(Reviewed by Elisabeth Herschbach).

Media Reviews

New York Times
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. Her voice is warm and often charming, though she has a weakness for whimsical asides...But such amiability was probably what got some reluctant sources to talk. One man sent her some crucial information while he was in the last stages of pancreatic cancer; another source agreed to an interview at her nursing home just before her 100th birthday. Without Cahalan’s intrepid reporting, the truth of Rosenhan and his paper might have been lost.

NPR
Cahalan seems at sea at this end of this book. I think she went in intending to write one kind of book — about a reformer and his crusade to expose the tyranny of psychiatric labels — and then inadvertently ended up writing an exposé about the faulty policing of scientific research papers and the professionals who publish them. The Great Pretender is still worth reading because it illuminates a game-changing moment in the history of psychiatry in the U.S.; it just isn't as satisfying a book as Brain on Fire because it ends in the muddled middle of things.

New York Journal of Books
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.

Publishers Weekly
Fascinating...Cahalan sets a new standard for investigative journalism...Her impeccable inquiry into the shadowy reality of Rosenhan's study makes an urgent case that the psychological and psychiatric fields must recover the public trust that 'Rosenhan helped shatter.

Kirkus Reviews (starred review)
Cahalan draws a vivid and critical picture of Rosenhan and the ramifications of his most prominent work. A well-told story fraught with both mystery and real-life aftershocks that set the psychiatric community on its ear.

Library Journal (starred review)
[B]rilliant...Indispensable reading for aficionados of Cahalan's Brain on Fire and Merve Imre's The Personality Brokers.

Author Blurb Ada Calhoun, author of St. Marks Is Dead and Wedding Toasts I'll Never Give
Breathtaking! Cahalan's brilliant, timely, and important book reshaped my understanding of mental health, psychiatric hospitals, and the history of scientific research. A must-read for anyone who's ever been to therapy, taken a brain-altering drug, or wondered why mental patients were released in droves in the 1980s. And a thrilling, eye-opening read even for those who thought they weren't affected by the psychiatric world.

Author Blurb Andrew Scull, author of Madness in Civilization: A Cultural History of Insanity
The Great Pretender is an extraordinary look at the life of a Stanford professor and a famous paper he published in 1973, one that dramatically transformed American psychiatry in ways that still echo today. The book is fast-paced and artfully constructed—an incredible story that constitutes a tribute to Cahalan's powers as both a writer and a sleuth.

Author Blurb Luke Dittrich, New York Times bestselling author of Patient H.M.
The Great Pretender is a tight, propulsive, true-life detective story which somehow also doubles as a sweeping history of our broken mental health-care system...It is an amazing achievement, and there is no question it will go down as the definitive account of one of the most influential psychology experiments of all time.

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Beyond the Book

Fake Science

The Stanford Prison Experiment In The Great Pretender, former New York Post investigative reporter Susannah Cahalan uncovers evidence that Stanford University psychologist David Rosenhan fabricated at least some of the details in his famous 1973 paper "On Being Sane in Insane Places."

If true, this certainly wouldn't have been the only time a high profile researcher's work has turned out to be flawed or even downright fraudulent. A particularly brazen example is that of repeat offender Diederik Stapel, a former professor of social psychology at Tilburg University in the Netherlands. Stapel rose to prominence in his field with a series of studies that gained media attention around the world. One study purportedly showed that carnivores are more selfish than ...

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Readalikes

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