Reviewed by Sam Redfearn, age 15

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

The debate as to whether mental hospitals, and the notion of institutionalization as a whole, are the ideal system for the treatment of psychiatric patients in the US is something that has raged relentlessly since its invention. The abusive and exploitative nature of these hospitals initially extended far beyond their intended use. In the 1800s, psychiatrists would be bribed to hospitalize people for arbitrary reasons, and they became a commonplace solution to the question of where to put homeless and poor people as well as the mentally ill. In addition, the conditions in mental hospitals have sometimes been said to hurt their patients, scarring them through experimental treatments, far more than they helped them. Improvements have supposedly been made, but one professor, David Rosenhan, decided to test the system of mental hospitals once more. In his study, On Being Sane in Insane Places, he writes about sending nine perfectly healthy and sane individuals into mental hospitals with one fabricated symptom that was almost immediately dropped as soon as they were admitted into the hospitals, with the participants acting just as they would outside of the mental hospital and seeing if the doctors would notice and release them. In The Great Pretender, Susannah Cahalan takes a look at the long and complicated history of mental illness diagnosis, and tells the story of the cause, as well as the massive effects, of Rosenhan’s study.

As somebody who does not often read nonfiction books, and even more scarcely prefers them over fictional narratives, The Great Pretender has been an incredibly refreshing read for me. Cahalan’s style is comprehensive; there is never a moment where the book reaches beyond what someone reading about psychology for the first time would be able to understand, making it accessible and interesting. Nevertheless, it is full of information. In addition, Cahalan doesn’t end the book by making broad, sweeping statements or simplifying the evidence she’s collected, but rather, acknowledges that what she has uncovered is neither complete nor supports a single conclusion. Furthermore, the book includes a massive twist towards the end which is truly astonishing. In spite of being a highly informational book, The Great Pretender takes on the role of a magnificent narrative. A potential reader should be warned that some of the content regarding conditions in mental hospitals may be disturbing, but I would recommend this book to anyone who has not previously read much on the topic of mental illnesses and would like to start with an enthralling read.

4.5 stars.

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382 pages