Pretending to have a illness.

Hi, I read today of two psychologist who pretend to have a mental illness to enable them to go undercover in a attempt to investigate wrong doings in a psychiatric hospital, this ended badly for them as they then developed the real symptoms of the illness they were pretending to have leaving them both suffering with serious mental illness.

Although I feel this is a old wife's tale I would be interested on others thoughts because if there is something in it then it may be of some benefit in encouraging healthy actions and thoughts for people with a illness, Gary.

fiinch

you might be thinking of the Rosenhan experiment, as far as i can remember they didn't actually develop symptoms it's just that it was impossible to differentiate them from the actual patients, and it highlighted serious problems in psychiatric care

It's a doctor called Tim Cantopher who in his his book Depressive Illness stated that the two psychotherapists mimicked schizophrenia for 6 months and during that time they both devolped schizophrenia for real, which he suggests they still are suffering from today.

He wrote this to prove the theory that you can become the way you act which I find interesting as if true it maybe helpful to others, but I still can't get my head round it.

dar100

Can't recall the name of the researchers, but this experiment was carried out in America some time ago. Up to 50 Psychologists, faked symptoms of mental illness. Even after telling hospital staff of the reason they were there, they still failed to release them from the hospitals they were in.

It seems once a diagnosis of psychopathology is given to a person, professionals seem to see all future behaviour through a mental illness lens, even if this behaviour is quiet "normal"

This doctor has written that those pretending to have schizophrenia devolved schizophrenia for real and the pretending stopped.

The reason I'm interested is for the reverse effect for those with a mental illness developing a positive outlook even by pretending, to counteract the negativity from stigma, anxiety etc...

Valmont

gary71 wrote: »

It's a doctor called Tim Cantopher who in his his book Depressive Illness stated that the two psychotherapists mimicked schizophrenia for 6 months and during that time they both devolped schizophrenia for real

It is important to note that there is no way distinguish between someone 'faking' schizophrenia and somebody who has it for 'real'. Even if they say they are faking it a psychiatrist simply has to disagree with them for the diagnosis to stand. Do you have any more details on this particular case, Gary? I would be very curious to know on whose authority they were judged to have it for 'real'.

Let's not forget that these people were mentally ill in the first place for pretending to have a mental illness (factitious disorder).

Valmont

gary71 wrote: »

This doctor has written that those pretending to have schizophrenia devolved schizophrenia for real and the pretending stopped.

The reason I'm interested is for the reverse effect for those with a mental illness developing a positive outlook even by pretending, to counteract the negativity from stigma, anxiety etc...

I think you have just stumbled across the worst kept secret of the mental health industry. Before we can become anything, we must act like that something. If I don't like being a barman, I'm going to quit my bar job, stop drinking, and do something else. I'm not going to sit around talking to a psychiatrist and taking pills waiting for my brain to heal while I make no effort to change my own circumstances, beliefs, or thoughts. In this way it is easy to see how mental illness strips people of agency -- the one thing they will need to rely upon to 'get better'.

dar100

Valmont, these two professionals went undercover to investigate psychiatric institutions, to say they are mentally ill because they faked mental illness is a bit over the top

JuliusCaesar

gary71 wrote: »

It's a doctor called Tim Cantopher who in his his book Depressive Illness stated that the two psychotherapists mimicked schizophrenia for 6 months and during that time they both devolped schizophrenia for real, which he suggests they still are suffering from today.

He wrote this to prove the theory that you can become the way you act which I find interesting as if true it maybe helpful to others, but I still can't get my head round it.

Does Tim Cantopher provide a reference for this? It sounds highly unlikely that a person would develop a severe mental illness such as schizophrenia unless they were genetically susceptible to it. As filnch says, it sounds like a half-remembered, wrongly-remembered Rosenhahn experiment.

Valmont

dar100 wrote: »

Valmont, these two professionals went undercover to investigate psychiatric institutions, to say they are mentally ill because they faked mental illness is a bit over the top

I completely agree but is the act of faking a mental illness not the exact description of factitious disorder? Why should we say that these psychotherapists don't have factitious disorder and another person does? If we are going by the individual's motivations for behaving in this way as a criterion for having factitious disorder then surely we have lost any semblance of objectivity?

Valmont

JuliusCaesar wrote: »

Does Tim Cantopher provide a reference for this? It sounds highly unlikely that a person would develop a severe mental illness such as schizophrenia unless they were genetically susceptible to it. As filnch says, it sounds like a half-remembered, wrongly-remembered Rosenhahn experiment.

I agree, I would have thought an event laced with such significance and controversy would have made its way through the grapevine by now? Maybe I'm just looking in the wrong places.

Valmont

On the topic of pretending to be mentally ill, what do people make of factitious disorder? Can impersonating a mentally ill person be a mental illness itself?

JuliusCaesar

JuliusCaesar wrote: »

Does Tim Cantopher provide a reference for this? It sounds highly unlikely that a person would develop a severe mental illness such as schizophrenia unless they were genetically susceptible to it. As filnch says, it sounds like a half-remembered, wrongly-remembered Rosenhahn experiment.

Sorry he's thin on references, here's the bit my question stemmed from:

Searching for okness, if you haven't got it, isn't easy and may require some psychotherapy. However, it may just need talking to friends and (benign) family. Listen to what they say about you, believe it and try acting as if you liked yourself the way they like you.

The reason this works is the basic psychological principle that you become the way you act.

This was demonstrated some years ago now in a mid-state of the USA. Two psychologist reacted to reports emerging from the two state psychiatric hospitals that the staff were mistreating the patients. This couldn't be proven as, whenever anybody officially inspected the hospital, the staff were good as gold. So the psychologists therefore determined to get themselves admitted, incognito, one to each hospital, posing as schizophrenic patients. They decided on the delusions and hallucinations they would simulate in advance and went ahead and got admitted as long-term patients. The plan was that after six months, both of them would emerge at the same time, declare that they were psychologists and present their findings to the world. The trouble was, when the time came, they were both schizophrenic and, as far as I know , remain so to this day.

Dr Tim Cantopher consultant psychiatrist.

JuliusCaesar

A psychiatrist is a psychiatrist.

A psychologist is a psychologist.

They tend to see mental illness as a biomedical event; we tend to see them as biopsychosocial effects.

I have never heard of anything like the study Cantopher describes - the only one even vaguely similar is the Rosenhahn one. I do not think you can 'bring on' schizophrenia by pretending to be schizophrenic. (Unless you have a pre-existing predisposition.)

There are other ways of finding out what goes on in a hospital other than getting yourself secretly admitted! Surprise inspections will generally do it - see the recent on in a prison in the UK where they found staff were denying prisoners meals as punishment (today's Guardian newspaper).

JuliusCaesar

Valmont wrote: »

On the topic of pretending to be mentally ill, what do people make of factitious disorder? Can impersonating a mentally ill person be a mental illness itself?

Are you talking about Munchausen's?

Valmont

JuliusCaesar wrote: »

Are you talking about Munchausen's?

If I recall correctly Munchausen's is a factitious disorder.

JuliusCaesar

You are of course correct. However, I don't think that somebody pretending to have a mental illness is suffering from a factitious disorder, in the same way as me pretending to be drunk makes me an alcoholic.

There are differences in motivation and insight.

Valmont

JuliusCaesar wrote: »

You are of course correct. However, I don't think that somebody pretending to have a mental illness is suffering from a factitious disorder, in the same way as me pretending to be drunk makes me an alcoholic.

There are differences in motivation and insight.

What alleged motivation or insight would constitute a diagnosis of factitious disorder?

dar100

Valmont wrote: »

I completely agree but is the act of faking a mental illness not the exact description of factitious disorder? Why should we say that these psychotherapists don't have factitious disorder and another person does? If we are going by the individual's motivations for behaving in this way as a criterion for having factitious disorder then surely we have lost any semblance of objectivity?

Valmont, I would differentiate between an individual faking mental illness for lets say, the purpose of seeking attention, to gain personal benefits, escape consequences etc. As opposed to a professionally trained psychologist looking to research an aspect of the mental health system and needing to fake a disorder.

In the first case I mentioned, I would argue that this behaviour may be indicative of underlying psychopathology, to a greater or lesser extent. In the second case I would imagine there has been a lot of planning put into the idea and would happen with group consensus.

HansHolzel

A psychologist going by the name of Julius Caesar. Verrrrry interesting :-)

Valmont

dar100 wrote: »

In the first case I mentioned, I would argue that this behaviour may be indicative of underlying psychopathology, to a greater or lesser extent. In the second case I would imagine there has been a lot of planning put into the idea and would happen with group consensus.

But here we end up in a situation where a 'diagnosis' of underlying psycho-pathology is solely dependent on the approval or disapproval of certain alleged motivations. We can take this approach on a pragmatic basis but we must acknowledge that any semblance of objectivity has gone down the toilet.

HansHolzel

In these great times the army doctors took unusual pains to drive the devil of sabotage out of the malingerers and restore them to the bosom of the army. Various degrees of torture had been introduced… There were stalwart men who endured all five degrees of torture and let themselves be carried off to the military cemetery in a simple coffin. But there were also… souls who, when they reached the stage of the enema, declared they were now well and desired nothing better than to march off to the trenches… In the garrison prison Švejk was put into the sanatorium hut among… malingerers of this very type.

“I can’t stand it any longer,” said his neighbour in the next bed, who was brought in… after having had his stomach pumped for the second time. This man was shamming short-sightedness… In the bed by the door a consumptive who was wrapped up in a cold wet sheet was slowly dying.

“That’s the third this week,” observed his neighbour on the right. “And what’s your trouble?” “I’ve got rheumatism,” answered Švejk, upon which there was a hearty guffaw all round. Even the dying consumptive, who was shamming tuberculosis, joined in the laughter.

“Don’t try to climb in here with rheumatism,” a fat man warned Švejk solemnly… “We even had a fellow here who was deaf and dumb. For a fortnight they wrapped him up every half hour in a cold wet sheet and every day they gave him an enema and pumped his stomach. All the nurses thought he’d won through and would go home, when the doctor prescribed him an emetic. It could have torn him in half and so he lost courage. “I can’t go on being deaf and dumb,” he said. “My speech and hearing have returned.”

“The chap who held out longest of all was the one who had been bitten by a mad dog. He bit, he howled… but he just couldn’t manage to foam at the mouth. We did our best to help him. Several times we tickled him for a whole hour before the doctor’s visit until he had convulsions and got blue all over, but the foam wouldn’t come… When he gave in one morning at the doctor’s visit we were quite sorry for him. “Humbly report, sir, the dog I was bitten by may not have been mad after all.” The doctor gave him such a queer look that he began to tremble all over and went on: “Humbly report, sir, I wasn’t bitten by a dog at all. It was I who bit myself in the arm.”

“The best thing to sham,” said one of the malingerers, “is insanity. There are two of our teachers lying in the ward next door and one of them shrieks out incessantly day and night… And the other one barks… They’ve managed to keep it up for three weeks now. Originally I wanted to be insane too, have religious mania and preach about papal infallibility, but in the end I fixed myself up with cancer of the stomach from a barber… for fifteen crowns.”

… “I had my leg dislocated for ten crowns,” came a voice from the row of beds by the window, “for ten crowns and three glasses of beer.” “My illness has cost me more than two hundred already,” announced his neighbour, a dried-up stick... “I’ve taken mercury chloride, I’ve breathed in mercury fumes, I’ve chewed arsenic, I’ve smoked opium, I’ve sprinkled morphine on bread. I’ve swallowed strychnine, I’ve drunk a solution of phosphorus in carbon sulphide as well as picric acid… No one knows what kind of illness I have.”

“The best thing to do,” explained somebody from the door, “is to inject paraffin under the skin of your arm. My cousin was so fortunate as to have his arm cut off under the elbow and today he has no trouble for the rest of the war.”