Goodreads helps you keep track of books you want to read.

Start by marking “The Great Pretender: The Undercover Mission That Changed Our Understanding of Madness” as Want to Read:

Other editions

Enlarge cover

Rate this book

Clear rating

1 of 5 stars 2 of 5 stars 3 of 5 stars 4 of 5 stars 5 of 5 stars

Open Preview

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

Susannah Cahalan (Goodreads Author)

3.63 · Rating details · 7,955 ratings · 1,094 reviews

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 psychi ...more

Get A Copy

Hardcover, 382 pages

Published November 5th 2019 by Grand Central Publishing

More Details... Edit Details

Friend Reviews

To see what your friends thought of this book, please sign up.

Reader Q&A

To ask other readers questions about The Great Pretender, please sign up.

Lists with This Book

Midnight in Chernobyl by Adam Higginbotham

How to Hide an Empire by Daniel Immerwahr

History Published in Year: 2019

371 books — 99 voters

On Earth We're Briefly Gorgeous by Ocean Vuong

TIME’s 100 Must-Read Books of 2019

100 books — 81 voters

More lists with this book...

Community Reviews

Showing 1-30

Average rating 3.63 ·

Rating details

· 7,955 ratings · 1,094 reviews

Sort order

Start your review of The Great Pretender: The Undercover Mission That Changed Our Understanding of Madness

Jul 24, 2019 Susannah rated it it was amazing · (Review from the author)

A writer friend always rates her own books. She explained that if she doesn’t love her own book enough to give it five stars, how can she expect anyone else to do the same? I like this mentality so here I go!

flag 614 likes · Like · see review

Sep 02, 2019 Julie Ehlers rated it liked it

Shelves: galleys, shelf-awareness

Back in the early 1970s, Dr. David Rosenhan published the results of a study wherein he and several other people (so-called “pseudopatients”), none of whom had ever had mental health issues, attempted to get admitted to psychiatric hospitals by showing up and claiming they heard a voice in their head saying “empty,” “hollow,” and “thud.” All of them got admitted on this basis, most of them receiving a preliminary diagnosis of schizophrenia. Once admitted, they behaved like their normal selves, b ...more

flag 208 likes · Like · see review

Sep 20, 2019 Nenia ✨️ I yeet my books back and forth ✨️ Campbell rated it it was ok

Shelves: les-arcs-de-triomphes, nonfiction, history

Instagram || Twitter || Facebook || Amazon || Pinterest

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 lo ...more

flag 53 likes · Like · see review

Oct 31, 2019 Jennifer ~ TarHeelReader rated it really liked it

Have read Susannah Cahalan’s deeply personal memoir, Brain on Fire? She has followed-up that best-selling book with The Great Pretender, which exposes the suspenseful mystery behind an experiment that shaped modern medicine and mental health as we know it today.

David Rosenhan and his brave colleagues entered asylums undercover in order to come out diagnosed out the yin-yang, but better able to expose the atrocities and systemic problems in mental health treatment at the time. On top of that, Ca ...more

flag 53 likes · Like · see review

Nov 01, 2019 Book of the Month added it

Why I love it
by Maris Kreizman

Susannah Cahalan was not okay. Over the course of a month she went from being a fully functioning young reporter to suffering from psychosis and hallucinations, a step away from being diagnosed with schizoaffective disorder. In her devastating 2012 memoir, Brain On Fire, Cahalan details how a neurological disease not only caused her body to attack her brain, but also caused her to question her own sanity.

Susannah is fully recovered now, but what would have happened ...more

flag 45 likes · Like · see review

Dec 05, 2020 Trevor rated it it was amazing

Shelves: psychology, history, science

This is the year where I have gotten to learn that so many of the social psychology experiments I’d always assumed to have been completely above board are actually anything but. The Milgram, the Stanford prison, those experiments on the effect of plate size on how much you eat, and even the great marshmallow of delayed gratification – the real story behind each of these being somewhat different from the marketing hype. And learning that has proven to be deeply disturbing, because people have mad This is the year where I have gotten to learn that so many of the social psychology experiments I’d always assumed to have been completely above board are actually anything but. The Milgram, the Stanford prison, those experiments on the effect of plate size on how much you eat, and even the great marshmallow of delayed gratification – the real story behind each of these being somewhat different from the marketing hype. And learning that has proven to be deeply disturbing, because people have made real-world choices and decisions on the marketed version of those experiments. Decisions that have had lasting consequences on many, many people’s lives.

This book is also about one of these big experiments – Here’s the short version.

Being a social psychology experiment, of course, it involves deception. That fact alone makes me uneasy with the whole field, but let’s trudge along regardless. A group of people turn up at mental institutions across the country and claim that they can hear voices. The voices aren’t particularly nasty or anything. They say a group of words that imply emptiness. This is all the potential clients claim – they don’t claim to want to have sex with their mum or anything like that, just voices saying no more than “Thud, Empty, Hollow”. They are all admitted to hospital for various (and surprisingly long) times and they all left with a diagnosis of schizophrenia or depression. The paper that came out of this experiment spoke of how easy it is to fool the ‘doctors’ working in this field of diagnosis.

But it turns out that the ‘patients’ might not have merely said they were hearing voices. They might have said that they were considering suicide. They might have had the voices saying other things. They might have actually acted much more insane than was written up in the paper following this experiment. Still, the problem remains of a little craziness having very, very large consequences.

We have all seen the films – Who Flew Over the Cuckoo’s Nest – say, and we’ve all been outraged by how impossible it is to prove you are sane once you have been marked as insane. Goffman (something of a hero of mine) discusses this in a couple of his books too – Asylum and Stigma – and he gets mentioned here too, along with Foucault’s A History of Madness. I’ve read that too. I found it a bit uncomfortable reading this and feeling my perspective change on some of these questions. I guess like many other people, I’ve often thought of mental institutions as a close approximation to hell-on-earth. Needlessly cruel, acting out unspeakable inhumanity, the sorts of places that could reasonably have a sign above the door with ‘abandon all hope all ye who enter’ written on it. Closing them down was one of the truly liberating actions of the later part of the 20th Century – good riddance, and all that…

This book has made me aware of some shades of grey. It certainly isn’t that we need to reopen such hospitals and pump people full of drugs to keep them chemically restrained. Or to lacerate their brains to pacify them, or to give them electro-convulsive therapy to see what happens. The problem is that we closed these hospitals down and then dumped people with mental illness onto the street and left them mostly to care for themselves. The one constant in this story seems to be society’s utter lack of care for these incredibly vulnerable people. We saw a terrible situation, one where those who were being badly treated were concentrated in one place, and so we dispersed them, making it easier for us to pretend we couldn’t see what was going on anymore. Or we then put them into prisons – where we could define them in ways that made us their victims, rather than the other way around.

Obviously, Rosenhan’s experiment can’t be held solely responsible for all of this – no one event or person ever really is – but the experiment was clearly a sign of the times and the sort of clear example that made arguing against it seem to be about vested interests or akin to being the moral equivalent of pure evil. What I found most interesting is that Rosenhan had his paper published in Science – a generalist publication – but the author says that it would have been very unlikely to ever have been published in a specialist journal. This is because his evidence was so thin. In fact, the author suspects that a lot of his evidence was actually made up. That he only sent a couple of people into these hospitals and mostly just made up the rest of his data. We might never know if this is the case or not, but it seems possible given some strange facts about the data.

There was also the problem with one of the people she was able to track down who had been part of the experiment. His data hadn’t been included, it seems, because he was treated really well in the hospital he went to and he felt they couldn’t have been more helpful. Needless to say, normally in science you don’t dump results that go against your hypothesis, in fact, the whole point of an experiment is to disprove your hypothesis.

And this wasn’t the only problem with the experiment. It seems that the whole ‘we only said one thing and got dumped into the snake pit’ was a bit of an exaggeration too. It seems that rather than just saying ‘I’ve been hearing voices’ – they also said that their lives were falling apart, that they had been contemplating suicide and had even been socially isolating. Rather than the experiment being about how easy it is to get into a mental hospital, as Seymour Kety is quoted, rather colourfully, as saying of the experiment: “If I were to drink a quart of blood and, concealing what I had done, come to the emergency room of any hospital vomiting blood, the behavior of the staff would be quite predictable. If they labeled and treated me as having a bleeding ulcer, I doubt that I could argue convincingly that medical science does not know how to diagnose the condition.”

I really liked this book. What I liked most about it is that it is a couple of books in one. I don’t think the point is to come away from this book saying, ‘Bloody Rosenhan – made the whole damn thing up’ – but rather to see that some ideas are imminent, but that science ought to strive to be above what is in the air. I’m not entirely convinced it ever really can get beyond this, but I do think more of an effort could be expended than was clearly done here. Rosenhan is one of a largish group of scientists who have ‘known’ the truth and have been prepared to bend their data to make it conform. As the author also makes clear, many of those who knew his results were a bit smelly, still used them for their own ends.

I don’t want this to be a review that says, look at how we have been fooled by what this one man did. The point is, we wanted to be fooled. The ultimate fact is that if we want to know what we really think of the mentally ill, just look around at how we continue to treat them. Foucault says in his History of Madness that madness came into being as leprosy was being Irradicated in Europe. And we had these large hospitals and no one to put into them. That might be going too far, or it might not be. It is always hard to tell with the past. However, we are certainly overdue a new experiment to shame us again over our treatment of the mentally ill.
...more

flag 41 likes · Like · see review

Nov 15, 2019 D rated it did not like it

Very disappointing. This book is rather poorly written and its approach is exceedingly scattered. In my opinion, the author is not really qualified by either education or experience to write about the topics discussed. The actual purpose of the work remains elusive to the reader. Cannot recommend either the purchase or taking the time to read this.

flag 37 likes · Like · see review

Dec 06, 2019 Jenna Bookish rated it really liked it

If you’re going into this book expecting an in-depth rehashing of the Rosenhan experiment and its conclusions, you may be disappointed. I hold a BA in psychology, so I was already somewhat familiar with this study going into the book. While I did get some new information from The Great Pretender, it was not nearly as much as I’d hoped. Part of the reason for this is that the focus of the book is not super specific. The synopsis from the publisher gave me an impression of a very different book th If you’re going into this book expecting an in-depth rehashing of the Rosenhan experiment and its conclusions, you may be disappointed. I hold a BA in psychology, so I was already somewhat familiar with this study going into the book. While I did get some new information from The Great Pretender, it was not nearly as much as I’d hoped. Part of the reason for this is that the focus of the book is not super specific. The synopsis from the publisher gave me an impression of a very different book than I read.

Another reviewer (who enjoyed the book a lot less than I did) made the comment that it felt like Cahalan did a lot of research on peripheral topics for this book and didn’t want it to go to waste. Consequently, it all gets included. While I get where this person is coming from, I disagree. A lot of the history of psychology included in this leads directly into David Rosenhan’s reasoning for conducting his famous experiment. He sent healthy “pseudo-patients” into mental hospitals for two major reasons: to expose the hazy nature of psychological diagnostic criteria as they existed at the time, and to provide witnesses who would be palatable to the general public who could relay the treatment the mentally ill were receiving in these institutions. The historical backdrop did not feel superfluous.

Cahalan also delves into several other famous experiments, again in more detail than I would have expected given the blurb’s focus on Rosenahn. These major experiments are also relevant, albeit in a tangential way, because of the controversy surrounding them. The Stanford Prison Experiment (Philip Zimbardo) and Stanley Milgram’s experiment on obedience to authority. These experiments also share some thematic similarities with Rosenhan’s work; all of them explore the darker side of human nature in varying respects. Zimbardo purported to show that the overwhelming majority of people are capable of horrifically abusive behaviors towards another person in dehumanizing, institutional settings like prisons. Milgram’s experiment had an authority figure in a lab coat asking participants to administer electric shocks to people as part of an experiment on the effects of punishment on learning. The “teaching experiment” was actually a smokescreen, and the true purpose was to see how many people would agree to shock someone who was in pain, and to what degree.

All three of these experiments (Rosenhan’s, Zimbardo’s, and Milgram’s) have faced sharp criticism of their methodology, with Zimbardo facing probably the most scrutiny. Issues vary from the potentially inappropriate level of manipulation on the participants from the researcher to outright deceit.

Cahalan’s book explores a variety of issues surrounding psychiatry in a good amount of detail, some only tangentially related to the experiment referenced in the title. If your interest in this book is primarily out of a desire to understand Rosenhan’s research, you may end up feeling like you are wading through a lot of unneeded information in order to get it. However, if you have a more general interest in psychology and psychiatry, this may be an excellent book for you.

You can read all of my reviews on my blog, Jenna Bookish!
Facebook | Instagram | Tumblr ...more

flag 29 likes · Like · see review

May 03, 2020 Woman Reading rated it it was ok

Shelves: nf-medical-and-science, read-women-2020-challenge, nonfiction-2020-challenge, 2-stars-mental-junk-food, nfbc-botm-and-br

2.5 Stars - rambling and poor organization mitigated the impact of her research findings

If sanity and insanity exist ... how shall we know them?
- David Rosenhan

These questions not only began Rosenhan's seminal study, they shaped the bulk of Cahalan's The Great Pretender. Rosenhan was a Stanford professor of psychology and law when he published "On Being Sane in Insane Places" (OBSIP) in 1973 in Science. He described how eight healthy adults presented themselves as having auditory halluc ...more

flag 25 likes · Like · see review

Dec 04, 2019 Sierra Smith rated it it was ok

Shelves: authors-i-don-t-like

I love non-fiction. I love psychology. I thought I was going to love this book. I was wrong.

I hate that I found this book so very disappointing. The author states the book is about Rosenhan and his pseudopatient study which I was excited to learn more about after it was mentioned briefly during my undergrad degree. Maybe 1 1/2 chapters is about Rosenhan’s experience in a psychiatric hospital along with a few experiences mentioned by the other pseudopatients. This book is mostly a history of psyc ...more

flag 20 likes · Like · see review

Feb 06, 2020 Krystin Rachel rated it really liked it

Shelves: nonfiction, challenge-2020, 4-stars, mental-health, asylum-setting

Book Blog | Bookstagram

Opening Thesis: Everyone needs drugs
Main Diagnosis: SCHIZOPHRENIA
Plot Researchy-ness: Up to your eyeballs in straight FACTS

Before you go into reading this book, you must first understand the true premise. It is NOT a history of psychiatry and psychiatric hospitals, though those things are discussed to fully understand what Dr. David Rosenhan was doing. But this book is almost totally about Dr. David Rosenhan and his study from the 1970s that looked to expose how psychiatry ...more

flag 18 likes · Like · see review

Jan 21, 2020 Ashley rated it really liked it

Shelves: half-starsies, history, science-and-stuff, non-fiction, psychology, scholarship, mental-health, shop-on-your-own-shelves-2020, book-of-the-month

When I read Brain on Fire, Susannah Cahalan's memoir about her experience with psychosis, I became a little obsessed with it. (The Netflix adaptation was disappointing, as the clever hook in the book was her investigating her own illness from an outside perspective, something she could do as she lost most of her memory from when she was sick. The film just follows it straight. But that's a digression.) Brain on Fire is an extremely readable memoir about a very scary and rare thing that happened When I read Brain on Fire, Susannah Cahalan's memoir about her experience with psychosis, I became a little obsessed with it. (The Netflix adaptation was disappointing, as the clever hook in the book was her investigating her own illness from an outside perspective, something she could do as she lost most of her memory from when she was sick. The film just follows it straight. But that's a digression.) Brain on Fire is an extremely readable memoir about a very scary and rare thing that happened to Cahalan. Especially since the extremely rare illness she was diagnosed with⁠—anti-NMDA receptor encephalitis, an autoimmune disease that at the time had only been diagnosed in a couple hundred people, ever⁠—is a kind of disorder that is sometimes called a "great pretender," meaning it mimics the symptoms of other diseases and is thus hard to diagnose. In this case, Cahalan's body was attacking her brain, but doctors believed she was mentally ill.

After recovering from her illness, Cahalan became obsessed with what could have been, or the people she began to call her "mirror images." One woman in particular was diagnosed with the same rare disorder after her doctor attended a lecture that Cahalan gave, but she had been suffering with the condition for years at that point, and even after treatment, would never be able to fully recover as Cahalan was able to, because she was incredibly lucky and diagnosed so early. Cahalan's is full of encounters like this now, as talking about mental illness with strangers has become a regular occurrence. When an acquaintance brought up David Rosenhan's infamous study from the 1970s, where he sent eight "pseudopatients" undercover into psychiatric hospitals to test out psychiatry's ability to tell the "sane" from the "insane," and to question the efficacy of psychiatric diagnosis, Cahalan immediately wanted to learn everything she could. Rosenhan's study became a phenomenon when it was published, crossing over into the mainstream media, and altering the practice of psychiatry in pretty significant ways.

Cahalan began digging into the story, determined to learn about Rosenhan, track the effects of the study, and maybe track down the pseudopatients themselves (they were given pseudonyms in the published paper, which was titled "On Being Sane in Insane Places"). But as she starts her digging, she gradually comes to realize there are enormous holes in the story, and Rosenhan and his study were not what they seemed. I don't want to say more than that, because it's fun to watch her chase down clues, and uncover what actually happened.

Cahalan also uses the investigation into the study to look into the history of psychiatry itself. This was one of the main things I'm ambivalent about with the book. At times it felt scattered, as other reviewers have pointed out, she follows a lot of "tangents." I keep going back and forth about whether those tangents were actually tangents at all, but instead purposeful insights into a greater picture that Cahalan was trying to present. But it was still a little messy and confused in execution; I think I would have appreciated more clarity. But I do think it was a necessity for her to not write about this study in a bubble. You need to know about a lot of it to understand the impact the study had on the field, and why it feels like such an urgent topic still today to Cahalan.

It was very unsettling throughout the book to realize just how much we still don't know about mental illness, as one psychiatrist she quotes in the book says, all we have are "signs and symptoms," and though other reviewers have accused Cahalan of an anti-psychiatry bias, I don't think that's what's going on here at all. She's certainly in favor of psychiatry practices that don't dehumanize patients, and in favor of science that advances our understanding of the brain and how it works. She's also not afraid to bring up sticky questions, like how the mental illness stigma (and cognitive bias) often leads to misdiagnosis, and how disorders that have a physical cause in the body are taken so much more seriously than the murkier conditions like bipolar or schizophrenia, or even clinical depression. She definitely is advocating for an approach that eliminates the distinction between a medical diagnosis and a mental one; she argues that mental diagnoses are medical, even if we don't yet understand the causes. (Her own case is pretty damning; she says the way she was treated was markedly different after she received her medical diagnosis, as compared to how she was treated when doctors thought she might have schizoaffective disorder, or maybe she was just "partying too much.")

One of the things I found fascinating about the book was that even as Rosenhan's study exposed flaws in the system, and produced massive change (a new standardized approach to diagnosis in the DSM-III for one thing), it also had massive consequences for the future of institutionalized psychiatry. There was already a growing anti-psychiatry movement in full swing by the time the study was published, one of the reasons it hit so big, and afterwards, many hospitals were closed, and those that are now left are massively underfunded. The need for psychiatric beds, according to Cahalan, is at minimum 95,000 heads in the USA. It is easier to get into Harvard in some cases than to get a bed and treatment when it is needed. Something I didn't know before this was that JFK's sister, Rosemary, had a developmental disorder due to oxygen deprivation at birth, and what ended up happening to her was so horrific, JFK decided to devote himself to the idea of ending barbaric practices on patients (like lobotomies) and to promote community care with government funding (a more holistic approach that focuses on humanizing patients). But because he was assassinated, the only part of his plan to be put into effect was the closing of hospitals, and the funding for different types of programs never materialized.

Despite it's scattered-ness, I'm really glad I read this, and I hope people who can make a difference in our mental health care system will also read it.

[3.5 stars, rounding up] ...more

flag 18 likes · Like · see review

Nov 05, 2019 Rachel Quinn rated it it was ok

The Great Pretender by Susannah Cahalan
My Rating: 2/5 stars

Let me start by saying I typically tend to enjoy an non-fiction reads. I love learning and the plot of this book was so interesting to me. I mean it claims to be the real story of eight people who went undercover as psych patients into asylums in the 1970s. It sounds so exciting and enlighting. Well the most exciting part was the summary on the back cover.

The writing style of this book is awful. It’s like a drunk aunt or a wild college ...more

flag 16 likes · Like · see review

Dec 11, 2019 britt_brooke rated it it was ok

Shelves: nonfiction

Cahalan questions the validity of David Rosenhan’s undercover psychiatric study. I’m skeptical of this book’s purpose. It just seems like a platform to further shout her disdain for psychiatry. Perhaps this could’ve been a worthwhile article, but as a book, it lacks the sagacity of Brain on Fire.

flag 14 likes · Like · see review

Sep 27, 2020 Mariah Roze rated it really liked it

I loved Susannah Cahalan's first book: Brain on Fire, so I had to read her second book when it came out.

This book taught me so much about mental health, psychology and its developments and discoveries over the years and I learned A LOT about the lack of basis for diagnosing people.

"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 Ro ...more

flag 12 likes · Like · see review

Feb 06, 2020 Robert Sheard rated it liked it

I'm having a difficult time deciding how I feel about this one. First of all, the promotional text on the front cover is somewhat misleading and doesn't give me warm fuzzies about the actual conclusions of the book. But without telling you why (spoilers), this book is all about undercutting what you know regarding the field of psychiatry. In some ways, I think it may have been a better long-form article than an entire book, and the digressions to flesh out the history were the parts where my int ...more

flag 12 likes · Like · see review

Nov 18, 2019 Ashley Mullins rated it it was ok

While this was an interesting book, it is a dnf for me. The research is there and I understand the point of the book, however, it seems like a book written only to support her lack of belief in the mental health industry while ignoring all the beneficial and essential treatments available today.

flag 12 likes · Like · see review

Nov 08, 2019 Janelle Janson rated it it was amazing

Shelves: nonfiction, 2019

Fascinating! Review to come.

flag 12 likes · Like · see review

Jun 04, 2020 Diane S ☔ rated it really liked it

Shelves: nfr-2020

Thought soon.

flag 11 likes · Like · see review

May 27, 2020 Leah Rachel von Essen rated it did not like it

Shelves: did-not-finish

In The Great Pretender, Susannah Cahalan wishes to write about mental illness and the ways that the system of psychiatry is broken. Her starting point was her own experience, when a misdiagnosis of schizophrenia almost kept doctors from finding her rare brain condition.

This book had a lot of potential to describe the true failings of past and modern psychiatry through the lens of Rosenhan’s famous study where several healthy people had themselves committed to mental institutions to see how they In The Great Pretender, Susannah Cahalan wishes to write about mental illness and the ways that the system of psychiatry is broken. Her starting point was her own experience, when a misdiagnosis of schizophrenia almost kept doctors from finding her rare brain condition.

This book had a lot of potential to describe the true failings of past and modern psychiatry through the lens of Rosenhan’s famous study where several healthy people had themselves committed to mental institutions to see how they would be perceived. Unfortunately, I had to stop about a quarter of the way through, because Cahalan’s antagonism to psychiatrists is so heavy as to be irresponsible. I know many of the studies she references, and I have done a lot of reading about anxiety, about the history of psychiatry and mental illness treatment, and about misdiagnosis (particular in women). So, particularly for the studies I was most familiar with, I can comfortably say that her conclusions are often speculative, she wildly simplifies many circumstances or studies, and she presents many generalizations as fact. Cahalan’s bias is understandable given her personal experience, but has no place in a text that presents itself as a nonfiction historical account and analysis.

Cahalan had an immense opportunity with this book to dig deep into the stigma against the mentally ill. She had a thesis hiding under the muck: the idea that once you are labeled as schizophrenic or manic depressive or mentally ill in some other way, it is nearly impossible to prove sanity given the bounds of current mental health understanding; the idea that once labeled, everything else you do is filtered through the lens of what is in your file, and the possibility of misdiagnosis is rarely considered. The treatment of people in hospitals, the relentless boredom of mental health facilities, and other such issues, are under-examined as well. It’s all lost under Cahalan’s speculation and bias that cast psychiatrists as villains.

Early in the book, Cahalan acknowledges that she was once critiqued for unfairly providing mental and physical illness as a dichotomy between unreal and real. And yet she continues to perpetuate the idea that psychiatrists are plotting and making it up as they go along, and that insanity and sanity are in a clear binary. For example, in telling her own story she says that her family fought against her being diagnosed with schizophrenia—they said that “I was acting crazy, sure, but I was not crazy.” She writes that, “It wasn’t me. Something had descended upon me in the same way that the flu or cancer or bad luck does.” (Italics are Cahalan's own in both cases.) This hit me hard as a prime example of the stigma against mental health that she later claims to be fighting against. My depression and anxiety aren’t me either, they are illnesses that I too cannot control. And she seems to ignore neurotransmitters completely—she mentions dopamine and other brain chemistry as new “terminology” without ever acknowledging that this is the physical basis for mental illness, dismissing a prime and necessary place for her to examine the link between mental and physical. At another point she writes: “When doctors diagnosed me with an organic illness (as in physical, in the body, real) as opposed to a psychiatric one (in the mind, and therefore somehow less real), it meant that I’d receive lifesaving treatment instead of being cordoned off from the rest of medicine.” (Again, italics are Cahalan's own.)

I have been misdiagnosed before. Several times, in fact, although this time in particular was terrifying. It wasn’t as deadly as in Cahalan's case, don’t get me wrong, and so I don't claim to grasp Cahalan’s pain. But last fall, I came down with lightheadedness, the feeling that I was short of breath, my heart pounding, and a fullness in my chest accompanied by sharp pains in my left ribs. When a doctor X-rayed my chest and found that my lungs were fine, his immediate next step was to tell me it was my anxiety. So I’ve been there. I have had a medical professional tell me that my illness was mental. I understand the pain and stress that comes from that, and the anger that follows—the anger knowing that a medical professional sent me home, advising me to stop taking my antidepressants and to not trust my psychiatrist without getting a second opinion from a primary care doctor. The anger knowing he did all that while I had pericarditis, which the cardiologist I would finally eventually see said was easily diagnosable, but which had gotten worse by the week, and if it had gone on unchecked, could have developed life-threatening complications.

I know that kind of anger, and I would be fascinated to read Cahalan’s memoir. But here, Cahalan has brought that anger into a troubling place. She is projecting her anger onto psychiatry, blaming it and its methods for its inability to diagnose definitively, something that is not limited to the world of mental illness. Some of her best writing in this book is around the stigma of being mentally ill, and yet she seems to lack the ability to turn that inward onto her own analysis and judgment of the field. She doesn’t interrogate why the mental health field is so behind other medical ones—the lack of funded research, the stigma itself, the prejudices against those commonly labeled insane (such as the disabled, women, people of color, queer people). In her analysis of the Rosenhan study she fails to consider that committing yourself into a hospital because you are hearing voices would inevitably lead doctors to trust your own reporting of hearing voices, and that a doctor releasing a person with the diagnosis of “schizophrenia in remission” makes a lot of sense when the patient says “I was hearing voices, I’m not any more,” and seems sane.

Overall, I’m deeply disappointed with this book and ultimately stopped reading it at page 140 because I did not want to feed my brain misinformation, and so felt I was getting frustrated without getting anything out of the text. Her bias against psychiatry and her bias, to be frank, against mental illness as something “unreal” were so pervasive that they inhibited my ability to enjoy the text. Once I realized how much that bias was also impacting the facts, this ceased to be a useful read. ...more

flag 10 likes · Like · see review

Oct 10, 2019 Book Lovers Pizza rated it really liked it

Full review on my blog: https://bookloverspizza.com/book-revi...

Wow, this was a really eye-opening look at the history of how we deal with people struggling with mental illness in this country. I read Cahalan's previous book, Brain on Fire, and really loved the description of her progression from how she wrote that book into this one. In short, she came to the realization that people (including doctors, nurses, etc) treated her differently once she was diagnosed with auto-immune disease vs. thin ...more

flag 9 likes · Like · see review

Jun 19, 2020 Morgan rated it it was amazing

It would not be remiss to call this book an exposé.

A fascinating and in-depth exploration into David Rosenhan’s ground-breaking experiment published in 1973 "On Being Sane in Insane Places".

The experiment involved 7 (or 8?) pseudopatients (including Rosenhan himself) having themselves admitted into mental institutions under false pretenses. Rosenthan’s paper presented some damming results for the institutions and psychiatry in general.

The publication of this ‘experiment’ shook the psychiatric ...more

flag 9 likes · Like · see review

Dec 12, 2019 Chloe Smith rated it it was ok

While reading this book, I felt that the author after her (terribly distressing) experiences chronicled in Brain on Fire, developed a personal vendetta against psychiatry that colored her re-telling of the Rosenhan study.

She lambasted psychiatrists who have spent decades studying their discipline and cast doubts on the fact that psychiatry is directly related to the science of the brain (which it like.. totally is). Don't get me wrong, she also would mention very important topics that merit mor ...more

flag 9 likes · Like · see review

Nov 21, 2019 Nadine rated it really liked it

The Great Pretender is one of those nonfiction novels that is not for everyone. It’s information heavy and quite dry at times, but full of interesting and thought provoking ideas and concerns about the field of psychology and psychiatry.

The Great Pretender follows the author Cahalan as she dives deep into the 1973 ground breaking study about the treatment of patients at asylums. Cahalan sets out to discover the truth behind the study and interview its participants.

As mentioned previously, The ...more

flag 9 likes · Like · see review

Feb 05, 2020 vanessa rated it it was ok

Shelves: 2020, adult-nonfiction, listened-on-audiobook

My main issue with this book is how disjointed it feels. It wants to be a narrative about David Rosenhan and his 1973 pseudo-patient experiment. However, it does not deliver a cohesive detailing or explanation of the study. Cahalan attempts to track down the people who took part in the experiment, she enumerates all of the valid criticisms of Rosehan's study, and she tells us random tidbits about the history of psychiatry.
The author often discusses a number of points, but then will meander to o ...more

flag 9 likes · Like · see review

Feb 09, 2020 Sara Dahabović rated it really liked it

Shelves: omiljene-knjige, ebooks

I'm having a hard time deciding if this book deserves 4 or 5 stars. I have always loved Susannah's enthusiasm and writing style and I REALLY enjoyed this book, but then at some parts, I felt that she was jumping between ideas; she would start with the history of a professor or a psychologist and before getting into the point of why she brought them up she would go into several rabbit trails. If anything it reminded me with my conversations with my Ph.D. supervisor where 99% of the time we go int ...more

flag 9 likes · Like · see review

Mar 21, 2020 Jessica Jeffers rated it really liked it

Shelves: nonfiction

This would have been five stars if Cahalan had sunken her teeth into the meat of her story before the last 90-100 pages. The first half of the book gets bogged down by extensive histories of psychiatry as a science and as a practice, as well as the challenges of accurately diagnosing psychiatric conditions. This information is important, but I can imagine many readers growing bored before they get to the point where the story begins to grow truly interesting.

Trust me, once you get to chapter 19 ...more

flag 9 likes · Like · see review

Nov 14, 2019 Laci Long || Book Pairings rated it it was amazing

When I saw Susannah Cahalan had a new book coming out, I knew I needed to read it. I read Brain on Fire when I was going through my own neurological issues and it really hit me in the feels and has stuck with me. The Great Pretender does make references to Susannah’s experiences in Brain on Fire, so if you are interested in reading both I’d recommend reading Brain on Fire first.

Alright, back to The Great Pretender. This book explores the misdiagnosis of mental illness and the differential treat ...more

flag 9 likes · Like · see review

Apr 10, 2020 Tess Taylor rated it it was ok

Shelves: 2020, read-nonfiction, read-psychology

2- This really kills me, because as a psychology grad student and a big fan of Cahalan's Brain on Fire, I was really hoping to love The Great Pretender. Unfortunately, the main idea that this book occupies itself with never comes to fruition, which makes it feel unsatisfying and half baked. Reading this book felt like Cahalan was trying to put a puzzle together with pieces from 5 different puzzles. The Great Pretender probably would have been better as a more condensed piece of writing, like a V ...more

flag 7 likes · Like · see review

Sep 08, 2019 Sharon rated it it was amazing

I found this a very interesting read, this study led to some major shifts in how mental illness was thought about, diagnosed and treated and so it’s important that the study be real and accurate. This is a well written and well put together account of what happened. If you are interested in psychiatry, then I would encourage you to take the time to read this book.

flag 7 likes · Like · see review

« previous 1 2 3 4 5 6 7 8 9 … next »

new topic
Discuss This Book

topics	posts	views	last activity
Nonfiction Nerds: January 2021: The Great Pretender	5	19	Feb 04, 2021 06:11AM
Play Book Tag: (Poll Ballot) The Great Pretender: The Undercover Mission that Changed Our Understanding of Madness by Susannah Cahalan	1	9	Jun 10, 2020 06:04AM
Non Fiction Book ...: The Great Pretender (May 1-Jun 15, 2020)	35	36	Jun 08, 2020 10:40AM

Readers also enjoyed

See similar books…

Genres

Nonfiction

600 users

Psychology

200 users

History

167 users

Science

135 users

Health > Mental Health

112 users

Audiobook

55 users

Mental Health > Mental Illness

42 users

Health > Medicine

36 users

Medical

32 users

Health

32 users

See top shelves…

About Susannah Cahalan

Susannah Cahalan

2,154 followers

Susannah Cahalan is the 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. She writes for the New York Post. Her work has also been featured in the New York Times, Scientific American Magazine, Glamour, Psychology Today, and others. ...more

Books by Susannah Cahalan

Deliler Arasinda Akilli Olmak; Akil Hastaligi Nedir, Ne Degildir?

More…

Articles featuring this book

48 New Paperbacks to Pick Up Now

There's something great about a paperback book: They're perfect book club choices, you can throw them in your bag and go, and they've been out in...

Trivia About The Great Pretend...

No trivia or quizzes yet. Add some now »

Quotes from The Great Pretend...

“But once you’ve come face-to-face with real madness and returned, once you’ve found yourself to be a bridge between the two worlds, you can never turn your back again.” — 5 likes

“Psychiatric epidemiologists are also finding that people born in winter months—during times of heightened flu and viral infections—may be more likely to develop serious mental illness (though people with more severe forms of the illnesses are more likely to be born in the summer months, so who knows).” — 3 likes

More quotes…

See a Problem?

Preview — The Great Pretender by Susannah Cahalan

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

Get A Copy

Friend Reviews

Reader Q&A

Lists with This Book

Community Reviews

new topic
Discuss This Book

Readers also enjoyed

Genres

About Susannah Cahalan

Books by Susannah Cahalan

Articles featuring this book

Trivia About The Great Pretend...

Quotes from The Great Pretend...

See a Problem?

Preview — The Great Pretender by Susannah Cahalan

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

Get A Copy

Friend Reviews

Reader Q&A

Lists with This Book

Community Reviews

new topicDiscuss This Book

Readers also enjoyed

Genres

About Susannah Cahalan

Books by Susannah Cahalan

Articles featuring this book

Trivia About The Great Pretend...

Quotes from The Great Pretend...

new topic
Discuss This Book