Nonfiction: The Great Pretender by Susannah Cahalan

The full title of today's book is The Great Pretender: The Undercover Mission That Changed Our Understanding of Madness by Susannah Cahalan. My excitement to read this book came almost exclusively from my experience of reading Cahalan's first book, Brain on Fire: My Month of Madness. That book was Cahalan's first-hand account of her experience with the rare neurological autoimmune disease known as anti-NMDA receptor encephalitis. It was fascinating, and also incredibly scary, and would lead Cahalan to pursue the topic of her second book.

Genre, Themes, History: This is a nonfiction book in which Cahalan looks closely at a study done in 1972 by Stanford psychologist David Rosenhan, who sent himself and seven other people into various mental institutions with specific instructions on how to act and what to say in order to gain admittance. Once inside, these psuedopatients were to act as themselves and record what it was like inside, what diagnosis they received, and what it took to get themselves released. According to Rosenhan, all but one was given the diagnosis of schizophrenia, much like Cahalan was before the true cause of her symptoms was discovered. Upon publishing his findings in an article titled "On Being Sane in Insane Places," Rosenhan caused a great fuss that would affect many aspects of psychiatry (and how it is viewed), including The Diagnostic and Statistical Manual of Mental Disorders (or DSM), and the closure of many mental health facilities. But as Cahalan digs deeper into Rosenhan's study, and attempts to hunt down the psuedopatients whose experiences were so crucial to the article, she begins to uncover some truths that not only invalidate the study, but make its effect on what we now believe about psychiatry incredibly troubling. Driven by her own experience, Cahalan will pursue every lead she can find, though many will go nowhere, in an attempt to uncover every truth behind this controversial study.

My Verdict: Whatever made Brain on Fire so engaging and interesting seems to be missing from The Great Pretender, at least in part. The topic is incredibly fascinating, but somehow the way Cahalan went about it sucked the fun out. The reader does learn about the experiment that sent eight psuedopatients into various mental institutions, but the book takes many pauses and diversions that take away from the overall effect of what Cahalan is revealing. Given a bit more focus and direction, the book would be more powerful. Also, it seems to be working against itself at points, or at the very least at cross-purposes. And given Cahalan's own history, it does sometimes feel as if she is attempting to settle a score against an industry that was ready to cast her aside due to a misdiagnosis. I wanted to love this book, mostly because I loved her first one. But The Great Pretender simply does not have the same power.

Favorite Moment: When Cahalan reveals to one of Rosenhan's pseudopatients that his experience was not accurately included in the study.

Recommended Reading: Brain on Fire is an incredible book, and I cannot recommend it enough.