Three Christs return and are waiting to be won

The New York Review of Books has just reprinted the classic book ‘The Three Christs of Ypsilanti’ documenting psychologist Milton Rokeach’s offbeat experiment where he brought three delusional Christs together in the same psychiatric hospital.

I wrote about the astounding but somewhat ethically dubious study in a recent article for Slate if you want some background and I’m pleased to see a new edition being printed, as even the out-of-print second edition was being sold for hundred of dollars.

The publishers have kindly offered a copy of the book as a prize, sent anywhere in the world, so we thought we’d run a quick competition (please note, although I’m quoted on the publishers’ page for the book, I’m not financially involved in any way).

Anyway, the competition is this:

You’re working in a psychiatric hospital and suddenly everyone thinks you’re a patient. How would you convince them you’re really a psychiatrist?

Leave an answer in the comments, I’ll pick the best one by the end of the week and the prize will be sent to you, anywhere in the world.

COMPETITION CLOSED: Thanks for all your wonderful entries. The winner has been announced although you’re welcome to continue to add your own fantastic ideas below if you’d like to join the fun.


Link to publishers page for The Three Christs of Ypsilanti.

114 thoughts on “Three Christs return and are waiting to be won”

  1. Glad to see they reprinted this one.

    As for your question, I thought Rosenhan covered this one already? 🙂

    I suppose my only recourse is to pretend that I’m a malingerer. Embellish any expected symptoms, add non characteristic qualities to symptoms, etc.

  2. I would convince them that they are all psychiatrists, then point out the improbability of my being the only patient in the institution.

  3. Convincing them that I am a staff member would be straightforward; staff members usually have picture IDs (badges), and I will be able to answer questions that only trained staff is supposed to know. On the other hand, convincing them that I am not a patient is an entirely different matter, unless this particular institution has a strict policy that precludes committing staff members. In general, it is impossible, as psychiatric normalcy is to a large extent conventional rather than objective.

  4. I would take a few approaches simultaneously.

    First, I would recommend they check my human resources folder, office, etc for evidence that I work there.

    Secondly, I would show my knowledge by giving in depth descriptions of less known psychiatric terms, drug side-effects, etc. Perhaps even asking the staff to quiz me.

    I also really like eyepulp’s idea of asking who is paying for my therapy, I don’t think I would have thought of that one.

  5. By not responding to the antipsychotics prescribed for me–‘cos the real patients all do get better, don’t they? 🙂

  6. Either claims of THUD or proclaim myself the second coming of Wonko the Sane.

    For those not in the know: “John created his name for two reasons: to reassure people of his sanity, and to remind himself that a scientist, in having no pre-assumed notions, must be like a child; (“Wonko” was what his mother had called him in his youth)”

    Gotta love Douglas Adams!

  7. Depending on the willingness of the subjects to cooperate, I would ask them if they could prove that anything they perceived to be real was in fact that way in reality to everyone else. Being in a location full of psychiatric patients, it should be fairly easy to find someone to disagree with anyone about almost any point of fact. At this point I could claim to be anything I wanted, and logically it would be no less likely than anyone thinking that they are whatever they think they are.

  8. I would show them some ID and the GMC website, which would demonstrate that there was somebody with my name registered of most likely around the same age specialising in psychiatry. Next I would display my knowledge of UKFPO, the Foundation Programme, DOPS, mini-CEX, and other topics which only a doctor could possibly be interested in. Finally, I would ask for a validated score to be used to assess my symptoms.

  9. Go along with them and do what they say. If you’re open to the possibility that your claims to be a psychiatrist could be delusional you might be able to convince someone to do you a favor and check your records. If the records declare you to be a patient…well, you’ve just made the first step towards recovery.

  10. Find the admitting nurse or clinician. In asking questions about your being admitted, respond with mildly amused incredulity. Gradually reverse roles by assuming a professorial critique of the staff’s responses. Give praise and reinforcement for sound observations, but disapproval for poor observations and conclusions. End with: “This has been an interesting way to evaluate staff performance!”

  11. If everyone thought that you were a patient then the answer is simple. You ARE a patient in the psychiatric hospital. It is then that you have come to terms with that.

  12. Accept the idea that you are not a psychiatrist. Then try to treat yourself, using the positive results of this treatment as evidence to convince everyone that you are really a psychiatrist. If the treatment has no effect, then it won’t matter because you consider yourself a patient.

  13. Since this just happened to a relative of mine, I would examine a patient for 10 minutes, refuse to listen to anything she said, and then give her these diagnoses (the first being the exact opposite of who she is) and then sign a form indicating that she should be forcibly held in the mental facility for an additional 90 days: Schizoid personality disorder; Mood Disorder NOS; and Anxiety Disorder NOS. I think the NOS would be the clincher. (fortunately, in my relative’s case, a more sympathetic & logical psychiatrist let her out the following day).

  14. So I heard you’re being mistaken as one of the patients. You want to know how to prove your identity? The answer is this: Do your job. Make the people around you get well. It would be great if you could actually cure a few of them, using whatever means you have at hand (perhaps your heretofore unknown talent for therapy without the pills), but don’t worry too much about the results. You’ve just got to make sure that the staff are catching glimpses of your effort. If you merely present to them your medical knowledge, they’re going to recognize you as belonging to the same category as that guy who has been reading theoretical physics for the past two decades because he thinks he’s Einstein, literally. So instead, show them an unmistakable example of professional commitment, the kind that can only be cultivated through years of experience. They may be able to pull off your labcoat, but they cannot do the same for your work ethic. Being professionals themselves, some of the staff will eventually start developing a gut feeling that something is wrong. And that’s when you start making your case.

  15. Try your very best to act as insane as possible in as many different ways as possible. Exhaust yourself trying to act crazy

  16. First, find out if this institution is in Michigan. If so, then find two colleagues, persuade them to join you in acting out the role of a religious figure, but in a fundamentally bizarre manner.

    Then, I should think, everyone will have to agree you’re one of the three psycho Christs of Ypsilanti.

  17. I would give them a choice:

    They could either believe me and i would keep treating them or they could not believe me and then see what happens when i stop treating everyone

  18. As a ventriloquist, I would immediately put a sock on my hand and begin convincing the other patients that the sock was the doctor… then.. once they believed that, the sock would with regret..submit his resignation and promote me to position of chief psychiatrist. The staff of course would recognize the socks…as..any good chief psychiatrist always wears nothing but bright red socks. The inmates wear white. Pretty simple actually.

  19. I think I would just do what Silvio Berlusconi does every single day since he’s running Italy: act as a completely out of the norm freak. Since most of the crazy italians think that that is perfectly normal and vote him to run the country, I suspect that also everyone else in a psychiatric hospital will be convinced that I’m the only perfectly normal person in the hospital, hence, I’m not a patient, but a psychiatrist. But not just a psychiatrist, I’m THE psychiatrist, or even THE BEST PSYCHIATRIST.

  20. Being the most crazy of them all, showing that my craziness is so crazy that it can’t be true. And then, suddenly, stop, start being serious, say something like “This acting is heavy, but you should try it too. Being in the mind of a mad man gives you a different point of view”, wink and then continue acting like a patient.

    They think I am a patient? No… I choose to act like a patient 😉 If it doesn’t work, at least I will have fun. And free meals!

  21. Couldn’t you ask the sceptical staff to provide a psychiatrist who is willing to prove to you that they’re a psychiatrist? If you can match their proof, then by the institution’s criteria you’re a psychiatrist. Of course, as Leo points out, that doesn’t prove that you’re not also a patient…

  22. Well, since EVERYONE is convinced I’m a patient I have my work cut out for me. I have to convince both patients and the staff that I’m not a patient.

    To convince the other patients I’m really a psychiatrist I would find out what problems it is they had to begin with. I would then begin “treating” them without the knowledge of the staff. However, I would treat them completely contrary to what it is they really need. If someone needs certain medication to keep them calm or even tranquilize them, I’d push them to stop taking it and I would give it to someone else (presumably someone that doesn’t need it so that they then walk around in a stupid). They would grow to trust me and, by my influence, grow to distrust their staff (hopefully I’m in a ward full of Paranoids, it would make this much easier). I would also begin to tell them things to cause them to respond in negative ways. While doing this I would tell them to tell them only to speak of me as “The Purple Doctor”. I would have the words “Purple Doctor” written on my face at all times so that the staff may easily pick me out.

    When I’m finally confronted by the staff I would explain what I was doing and why. That my attempts (and apparent success) at disrupting life and treatment at the facility were my way of getting the attention of the faculty as well as showcasing my knowledge of psychiatric and/or the psychological practice. After intense negotiations I would be found to be a member of the staff and not actually a patient…

    …either that or a morbidly sadistic person with an “above average” knowledge of psychology and psychiatric medicine. If they refused to release me as a patient I would then spend the rest of my time writing the words “Purple Doctor” anywhere and every (with my own feces if necessary).

  23. You’re working in a psychiatric hospital and suddenly everyone thinks you’re a patient: Feels like a bad dream & I wish I

    could wake up to the reality & comfort of everyday life.

    Unless of course I was a psychiatrist, now a patient ‘cos I’m not my normal everday self anymore. My sense of being & self

    -awareness is damaged and am a entirely new personality in a different warp. [Tongue tied on what this condition is called.]. On those occasional moments of normalcy I try to convince them I really am a psychiatrist. I’d ask who admitted me here as a patient for recieiving therapy.

    Even if it were a collective prank, I’d ask who admitted me.

  24. You’re working in a psychiatric hospital and suddenly everyone thinks you’re a patient. How would you convince them you’re really a psychiatrist?

    Since the perceiving of my correct status occurred suddenly, then something went wrong with the professional staff (maybe they ate or drank something that is adversely affecting their capabilities–no use trying to convince mad/incompetent people that you are not mad. Since I already work there, I would use that knowledge quickly as possible (to avoid becoming the same as them, that is, eat/drink/breathe what they did) to leave.

    I would confer with psychiatrists/other professionals outside the facility that know both that I am a psychiatrist and that I am not a psychiatric patient. Then an emergency psych team would be sent back to the facility, including myself.

    Voila, then there would be staff who would know that I am staff and not a patient.

  25. I would ask them to play “12 angry men”, by Sidney Lumet, in the ward movie session, and them invite the staff for a discussion about my mental health, questioning if I’m crazy beyond reasonable doubt. It could work.

  26. We have two hypothesis. The “patient” and the “psychiatrist”. We need an independent outside judge to decide which of the two is true. But then, this judge needs to convince all in the hospital. Who might be this judge?
    1. Religious judges are not respected by most psychaiatrists.
    2. Scientist use similar methods to psychaiatrists.
    3. Legal court will probaly refer to psychaiatrists.

    What about Obama? He could make a decision and convince all. He is doing that all the time. In practice, we might not need Obama himself, but someone who behaves and looks like him. An actor might do. After all we need a change in belief and not a real demonstration.

    1. Have a sense of Humour… Damn! That would mark you as a Patient for sure! Probably Manic! (Unless it was Black Humour in which case you’re marked as depressive.)

  27. Hmm. This would be a toughie.I am pretty sure I wouldn’t be able to convince them through appeals to my character. Afterall, if they think I’m a mental patient then they would discredit any appeals I made to them about how ‘sane’ or ‘normal’ I actually was. I would have no other option but to resorting to other methods. For example, I might try to ask them to tell me how I got in the asylum, since I did not put myself here and I wasn’t forcibly put in by others as well.

  28. I wouldn’t. I would simply take the opportunity to study the system from the inside, have more intimate conversations with the other wards and remain calm until someone on the outside realized I was not a patient. Trying to get out is the best way to prevent it from happening.

  29. If you suddenly become aware that everyone thinks you’re a patient there is something strange ‎going on, either you are a psychiatric patient or you have suddenly developed a delusion. ‎

    In the event you have developed a delusion it is possible that everyone does not think you are a ‎patient, rather you just think they do. If this could possibly be the case it would be worth ‎discussing your fears with a trusted and qualified colleague. In any event this would save you ‎having to prove to everyone that you are a psychiatrist. This should be your first option.‎

    As mentioned by a previous poster, it is possible that you are both a psychiatrist and a patient. So ‎unfortunately just by proving you are a psychiatrist you will not disprove that you are a patient.‎
    Equally just because you have been working in the hospital it does not mean you are not a ‎patient. Many patients are allowed to take part in simple jobs around hospitals, while others may ‎think they are working, for example taking notes on other patients.‎

    However if you still need to prove that you are a psychiatrist and not also a patient I suggest that ‎you should try and prescribe drugs, a function that I imagine would be removed if you had been ‎committed. This should therefore prove that you are a psychiatrist and not a patient. ‎

  30. Answer: The question cannot be answered.


    The situation is based on a matter of perception, while the question is a matter of substantiating an alternate “reality” in the minds of the other people in the hospital.

    To elaborate, it is much like when you wrote about a psychologist’s personality having an effect on whether someone is diagnosed as a psychopath or not. If you are being diagnosed by the insane how would it be possible, if in fact you were sane or not, to convince them of your sanity if it diverged from their perceived reality.

    To rebut the question of authenticating your identity by cross referencing employee records isn’t their reality based on you having some form of psychosis anyway? After all, the last thing the staff is going to do is a background check on one of the patients claiming to be a doctor!

    But couldn’t you, as a psychologist yourself convince them of your position in the facility by proving that you are a psychologist through facts, quizzes and, the diagnosis of other patients? That seems to be quickest way for the already delusional staff to diagnose you with some form of schizophrenia, but at the very least you would be a very well read patient.

    ∴ I’ll have to agree and draw the same conclusion as Alejandro Hernandez who states “If everyone thought that you were a patient then the answer is simple. You ARE a patient in the psychiatric hospital. It is then that you have come to terms with that.”

  31. I would write a prescription. I find that the right prescription can solve pretty much any problem I encounter.

  32. Something similar actually happened to me, I was with a friend visiting his girlfriend who’d had some kind of breakdown. As we were waiting at the reception, a nurse came up & asked were we the new patients?
    before walking off, my friend immediately starting laughing out loud creating this noise a bit like hurhurhurhurhur but for what felt like a considerable time, where I attempted to disappear whilst willing him to shut up. to this day I don’t whether the nurse was serious or this was an attempt at humour. So my answer to this dilemma would be to laugh at them, as we left safely last time.

  33. Tell them that you are the only one wearing white coat!To follow him out of the hospital and see if they could make it.

  34. I think the question and/or the situation require an ironic answer because normal people as we define “normal” or according to the Oxford Dictionary, really like pumping irony and wicked humor.

    Answers such as “Am I being joked in here, because my time is really really running out, I still have lots of patients to attend to. Or do you want all of yourselves to be my patients and be treated.”

    Or “Wow, is this a drill for the upcoming film of M. Night Shyamalan? Because clearly, we do not need any rip-offs of Scorsese’s Shutter Island.”

    Or “Bravo! Was our institution rented for a general rehearsal of a theatrical presentation based on the defunct WB’s shows Charmed and Buffy? And their respective episodes: Brain Drain and Normal Again? I like it more on TV though.”


    These are my answers. Thank you.

  35. Since I am a psychiatrist I must be treating some patients and will know about certain details that only doctors have access to and not anyone else. They can cross check this information to find out the truth.

    1. No no no. Trying convince, explain, demonstrate, provide evidence. All useless.

      Heidi Everett expressed it best..
      “The psychiatrist doesn’t believe you. They’re not paid to believe you, their career depends on that important fact.”

      Read the rest of her excellent “Lessons to be Learnt” here…

      ps: Listen to Heidi’s music, it’s hauntingly beautiful and utterly relevant.

  36. Why do I have to convince them I’m a psychiatrist? It says so plain as a day on my admittance form.

  37. You said that I was “working in a psychiatric hospital”. But you did not actually say that I was a psychiatrist. I might be a janitor, or a cook. Since most people who work in a psychiatric hospital are in fact not psychiatrists, the odds are that I am not actually a psychiatrist. Any attempts to show evidence that I am already a psychiatrist will therefore likely fail. My task is therefore to lie. Since I already work at the hospital, people will already know me in my ‘normal’ role. I therefore need to convince them that I am actually a psychiatrist lying about my profession for some reason. I think the core of my approach will be ‘Well, take a look at those asshole psychiatrists around here. Would you want to admit you were one of them?’ When they answer ‘no’, I’d say ‘Me neither’. And then walk away with a knowing smile and air of confidence.

  38. You’re working in a psychiatric hospital and suddenly everyone thinks you’re a patient. How would you convince them you’re really a psychiatrist?

    I am assuming that, in this hypothetical, I really am a psychiatrist, that I’m now being treated as a patient, and that I don’t just have the liberty to leave the facility.

    1. If “everyone” refer to the patients…I wouldn’t try to change their impression. I’d take advantage of their misconception to observe them and communicate with them in informal settings. I’d try to find a way that our new “peer” relationship would allow me to help them that wasn’t available in a more hierarchical setting. And I would consult and work in conjunction with a colleague who would be the “official” doctor for their care. I wouldn’t struggle to define myself as a doctor with the patients, but if they realized that I was, I would acknowledge that they were correct, and credit their perspicacity.

    (Note: I’m not a psychiatrist, so I have no idea if that approach would be ethical or legal. If I were a psychiatrist, I would be interested in that approach within the constraints of actual professional codes.)

    2. If everyone refers to the patients and the staff of the facility…well, I have Kafkaesque nightmares like that. In that case, I’d be far more concerned with how the staff saw me than the patients.
    – I would try to get outside verification of my status: paperwork, witnesses, external colleagues, etc.
    – Assuming that didn’t work (it never does in my nightmares), or that outside communication isn’t possible, I’d assess the staff, and look for the people who seemed least invested in the delusion, and most open to considering other ideas. I’d work on people one at a time, and try to build up a critical mass, discreetly, until enough influential people on staff agreed I was indeed a staff member that this became the new official reality. (This strategy works with credentialism, too, of pulling up HR files, etc.)

    Given that once adopted, official realities are very hard to shift, I’d fully expect to fail. My survival strategy would be to act as a model patient, get discharged as early as possible, and then sue them. (And I’m not even by nature a litigious person.) A massive lawsuit might be the very thing to get their attention.

  39. Nothing. If the beds are OK and the food is good then as an overwrought, overworked shrink I’d take my meds (assuming they can find some with MY name on) and enjoy the R&R. And HBO.

  40. Just tell everyone to speak to my registrar. They will look after things while I’m at an important meeting.

  41. Well, since this was a sudden onset, I’m afraid I would have to first convince myself that I wasn’t a patient.

    First, I would check my pockets for it would be foolish to go anywhere without my credentials.. and my keys. Failing this I would have to assume I left them on my desk. Now, if only I could remember where my desk was…

    So as not to arouse any suspicion, I would calmly roam the halls looking for a placard with my name on it. I can’t seem to find it, but I suppose another look wouldn’t hurt.

    Of course, there’s always the chance that I’m a visiting psychiatrist brought in to consult on a particularly difficult case, so I will check the front desk to see if anyone with my name has checked in recently.

    If I have gotten this far and I still haven’t convinced myself, the only possible recourse may just be to accept my fate and go insane.

  42. 1) You wouldn’t have to. The medication will kick in soon enough.

    2) Deny all cigarette breaks…or that you even smoke at all.

  43. I would say to the other psychiatrists, “Oh, I am a patient, not a psychiatrist? Phew, now I can catch up on my New Yorkers,” then bring a stack of reading, ask for a quiet room, and enjoy the lovely grounds of this idyllic (Hollywood) asylum. As the psychiatrists come to evaluate me, look calm and relaxed, tell them I am feeling great, then ask them if they wouldn’t like to take a load off, read the most recent Atul Gawande, while I go next door and help the bipolar patient in a manic episode take his lithium.

  44. first, who cares what the patients think; they’re all crazy, remember?

    second, if i am not a patient, i would assume i have some sort of badge and/or keys. i would use them.

    i mean, this is trick question, right?

  45. Tell the mental health workers to shut the unit down, to withhold dinner and to revoke all privileges; go home for the night and let the MHWs sort it out. Whistle a song as you drive out of the parking lot.

  46. Considering the possibility of being medicated and exhibiting symptoms of mental illness, I would forge a letter with stamped envelope from a friend or family member. The letter would falsely indicate that a parent had died and I should have someone from the hospital contact them about atrending the funeral. They would hopefully resolve my problem.

    Let’s say I’m knee-deep in something more cinematic and thrilling, possibly starring Nicolas Cage, where the warden has it out for me. Then, of course, I’d weave a tale about my exploits robbing the National Geographic Museum… Gettysburg Address Letters as treasure map… convince the janitor to trade my freedom for 10 million in golden muskets… Highway bathroom break with cigarette… Set the place on fire. Escape and profit.

  47. You’re working in a psychiatric hospital and suddenly everyone thinks you’re a patient. How would you convince them you’re really a psychiatrist?

    1. Accept that I am a patient
    2. Show all signs of being cured and obtain a discharge
    3. Attend Medical School for 7 years and qualify as a psychiatrist
    4. Return to the institution and present my credentials

  48. The only sane response to an extended stay on a psychiatric ward is to lose one’s mind. Therefore, in order to convince them who you really are (or were) you must develop a convincingly florid delusion and deny fiercely any accusation that you are (or ever were) connected with the mental health services. But beneath the rabid, foul-mouthed, monstrously gesticulating patina you create, you must maintain an inner calm, an almost bestial, half-forgotten sense of regret. Such that anyone who converses with you will realise the truth, that you were once an eminent psychiatrist but that you have been reduced to an inchoate wreck by the very thing you once gave your heart to. Hence, you will express perfectly a parable on the folly of a System that seeks to medicalise human anguish and locate society’s failings within the individual. Thus moved, the Powers-That-Be will immediately take you from the wards and promote you to your former position as Head of Services. Note, however, that they will not believe for a minute you are really sane. Thus you’ll be made into a figurehead, while the shadowy Powers go on with their nefarious agendas and mind-control experiments as they always have. Too late! You’ll realise you’ve merely exchanged one form of institutionalisation for another, and the hollow cries that echo down from your office to the wards below will only serve as a warning to others.

  49. I seem to recall from my psychology courses a study in which students were embedded in facility as patients and the real patients were able to identify them while the staff treated them as real patients. Maybe convince the staff to poll the patients regarding your status.

  50. 1. The problem is that suddenly, the burden of proof is on my side. So, I check for evidence: Ask for a check of my vital records, immediately. This would include my medical forms. If I am a patient, they exist. They’ll include family, friends, and who the hell referred me there in the first place. If it’s my signature, who’s paying? If it’s voluntary commitment, check out immediately. If it’s involuntary, I ask the person who is responsible for my committment to review my case, and I ask the insurance company or payer for a case review.

    This will result in a comparison of paperwork- if it isn’t consistent, discrepancies will be discovered.

    I ask friends and family to provide evidence of my identity, both in certifications and field involvement. I observe their reactions carefully, because if they’re doubtful of the existence of such evidence, there’s a problem.

    2. If these hospital/medical/social records prove to be intact (and against my recalled experience) across all aspects of my case, indicating me as a patient- and all record of my outside involvement with the field has been erased, all record of my hospital employment has been replaced with the records of a patient, then I have no choice but to negotiate through the system as a patient. The burden of proof is on my side, and I have none. Training and knowledge will only prove a liability, as they will indicate a morbid amount of knowledge about mental health behaviours that could prove detrimental to my case if I bring it all up. So I don’t yet.

    3. Assuming that there is some serious disruption between my actual history (as I perceive it) and the paper trail that should prove it, I’m no longer qualified to act as my own diagnostician. Furthermore, I’m not qualified to treat any of the patients, even though I believe myself (and remember my history as) being trained to do so.

    4. I can, however, ask for a meeting with the person in charge of my case, and ask for a simple review of my history, and a clear statement of my diagnosis and treatment plan. These should give me an idea of what I’m dealing with, and where I’m starting. This is important, because if I’m there for a delusion of being a doctor, I have to immediately acknowledge cracks in the case, and ask who I really am.

    5. From there: I have to comply with the treatment plan in a reasonable manner, whether I have evidence of the disease they claim or not. I must acknowledge to the person in charge of my treatment that anyone can have significant illness that needs some help to recover from. I must NOT insist on my belief that I am something other than the paper trail expresses; I’ve already exhausted all possibilities for correcting it, and that hasn’t worked. If they’re trying to “treat” that out of me, I have to rationally and sanely deal with my dual identity- the one I remember, and the one I’m living in. This is the only way to remain a coherent individual when faced with ridiculous (internal or external) circumstances. I have no choice but to negotiate the reality that I am presented with: At this point, I must ask (but don’t have to determine for sure) whether the diagnosis and treatment plan seem accurate and/or helpful. I don’t have to determine which “reality” is correct yet; I only have to negotiate the one I’m in.

    I comply with the treatment plan cheerfully and with enthusiasm. I take a sincere interest in people around me. One thing that hospitals never get over is burnout, both in the patients and the staff. A patient who’s highly motivated to recover gets attention, and a patient who’s maintaining normal social skills is a rarity. I have to keep those up.

    6. I have to get released from the hospital. This doesn’t mean playing along; it means establishing a state that matches the intended treatment plan goals. I must make my peace with the discrepancy between the reality I’ve experienced and the reality I’ve been confronted with. Reconcile it with good grace, denying neither and accepting the possibility of either. If it turns out that I’m wrong, and it’s a delusion, I’ve given myself the sound grounding to recover. If at some point I’m confronted with the fact that it’s all been a joke, a mistake, or an experiment, I’ve dealt with it in a relatively rational way, never losing my footing as the clinician I remember being.

    7. I have the unique, PRICELESS opportunity to observe from the inside what is working and not working in my hospital. I talk with the other “patients,” and see how they feel about their treatment and their treatment plans. I pay attention to the daily interactions of the interns and residents. I’m paying close attention to who checks my charts and who forgets, and whether the treatments people are getting are warranted/working. This is a hands-on look at the patient experience. During my stay, I learn everything I can about what works from the patient’s perspective.

    8. If the discrepancy between my perception of myself as a clinician and my paper trail is never resolved, then I have no choice but to work for my release, and upon release, recertify. This may mean returning to college. Whatever it takes, I have to re-establish my identity, and try to understand what happened to erase it. If I find that my case was a mistake or experiment, and my existence as I experienced it actually does match the social gap I left- I get to write a book about the experience, Dorothea Dix style, and share it with everyone else. We’ll call it, “Going Sane: The Burden of Proof.”

    At some point, I will either be returned to my former status, or re-establish it through a lot of work. Hopefully, I find out what the heck happened. When that occurs, I laugh, I accept it with humour and grace, and recommend it as a necessary part of anyone’s field training. I also immediately begin reforms that will prevent this from happening to anyone else- EVER.

  51. As the Fifth reincarnation of Jesus Christ, it would not be necessary to convince them I really am a psychiatrist.
    I would simply need to convince them that I have been sent by my Father to redeem mankind and forgive them for institutionalising the last three sons he sent – and to tell them to be nice to each other.

  52. How to convince a patient that one is indeed a doctor? A “badge” and “keys” probably matters little to someone who refuses to believe in such things.

    The book certainly sounds like it’s full of ideas…

  53. Award to Sol G., with riotous applause, if the overriding goal is to make the best of the situation – as, in life, it typically is.

    But if the goal is the narrower “convince the staff, the sooner the better”, I’d say this:

    Since they see you as a patient, they’re predisposed not to take you seriously; so it becomes a social-primate puzzle – how can a bottom-rung individual change his/her perception by the tribal leadership.

    (And if said tribal leadership has Dunning-Kruger qualities, it may not be easy…)

    You need to accept that you have influence, but not control; you can lead ’em to water, and so on. Doesn’t matter that you’re right, so ditch the indignation – what matters is changing their perception, and maintaining your mental health regardless of whether or not the project succeeds.

    IMO, you change their perceptions by behaving, subtly, as though _you’re_ the social dominant, & far enough above/detached that you have no interest in going head-to-head about it.

    Displaying this would involve making small, gentle, practice-related corrections to make them think: “have you noticed that…?”, “have you given consideration to the possibility that…?”, “how would you address the counterargument that…?”

    It’d also involve acting so as to bolster the dominance of an existing leader facing conflict – e.g., if 2 staff members disagree on something, tell the more correct one why you think s/he’s on the right track. People have marvelously open minds for what they want to hear…

    (This maneuvering does feel awkward & uncomfortable to someone who’s not socially dominant or motivated that way – but as a puzzle, it’s fascinating.)

  54. either, show them a map of my brain or if that fails show them the chemical structure of zyprexa or charge them for my time

  55. The only difference I have observed is that…..

    * Doctor’s behave as if they are eternally busy, have no time to dally, and are off to do something important.
    * The Docs have keys and a PDA.
    * The nurses recognize them.
    * … well that’s about it really. (White coats seem to be out of fashion these days)

    I dare say if a new student doctor misplaced his keys he could be in serious trouble. That’s probably why they stick so close to their mentor!

    As a visitor I found just by striding in confidently knowing where I was going worked better than any “vistors badge”.

    Look lost or uncertain you’re a visitor.

    Look distressed, bored, or pleading. You’re a patient.

    Bustle about and you’re staff.

    That is the simple practical everyday verified by observation and experiment truth of the matter.

  56. I like Anna’s solution. It’s a social game – kind of like how an outsider predator gets into a pack by playing their cards just right. Convince the other doctors that it’s them who are insane – after all, shouldn’t the cleverest doctor be in charge anyway?

  57. I would insist that I really did choose to become a psychiatrist and didn’t randomly pick it after washing out of my surgery rotation. Of course I went to medical school. Yes, I’m a real doctor!

  58. You cannot prove a negative. However, you can adopt an attitude that is demonstrably absurd, such as Bartleby the Scrivener, and insist that you “prefer not to” at every request until someone asks what you are up to. Then you state: I am demonstrating the absurdity of the situation I am in. This level of persistence, concentration, and sheer force of will seems beyond the capability of most psychiatric patients.

  59. I’d do everything they tell me to do (take my meds, eat my meals, do group therapy, etc.) but justify each and every one of those, with proper citations from psychiatric texts and scholarly articles. Oh wait, scholarship? That’s crazy behavior!

  60. I would remember that the best approach is “DON’T PANIC” and as long as I am on Earth, it’s “mostly harmless”. I would clutch my towel tightly and wait for the improbability drive to land me somewhere else.

  61. Easy, I would convince the psychiatrist he/she was actually the patient and ask them why I (the actual psychiatrist) was admitted when they are the individual needing assistance.

    But, I think the problem here lies in the question, how do you know you are working at the hospital and not actually a patient? How would you prove to yourself you don’t need to be there in the first place, and your “employer” is in all actuality your savior?

  62. Instantly realizing my kafkaesque situation, I stop worrying about convincing others that I am not a patient and start convincing myself that I am a patient. Hopefully, some ex-colleague of mine will notice how quickly I went from denying that I am a patient to accepting that I am a patient and find this abnormally abnormal.

  63. All the world is one great psychiatric hospital.

    And we are all its patients.

    Those among us who believe they are psychiatrists, are simply delusional anyway.

  64. You’d have to get help from the outside. In my case, I have a wife and kids, and my professors would have written letters of recommendation and so forth to get me in as a psychiatrist. Thus, any amount of contact with the outside world would reveal the discrepancy, and if contact was cut off, that would provoke an investigation by my loved ones.

  65. If logical reasoning proved pointless, I’d pull a McMurphy: run a card table, institute patient voting rights, take everyone deep-sea fishing, and generally raise the spirits of all the patients while making the staff deeply suspicious of me. I’d get the Chief to throw that control panel through the window BEFORE they lobotomized me, though.

  66. Since studies show that directly attacking a person’s perceptions and beliefs solidifies those very positions–even when cold, hard facts are used to refute them–the best thing would be an indirect approach. Simply act as if you are a doctor, and assuming you are a competent one, eventually people will start asking questions and investigate.

  67. 1. One cannot prove that one is normal, one can only demonstrate when one (or anyone for that matter) is abnormal.
    2. However, one can prove that someone is NOT abnormal in certain domains (but not all domains), so the answer to the question “Is X normal?” will be, at its best, always partial, incomplete.
    3. Hence, any effort to convince them that I am normal will always be insufficient, so my strategy will be not to convince them.
    4. In that sense, I agree with others who say “go along”

  68. I would take my meds, go to group, eat at mealtime, get along with others, partifipate in art therapy, agree with the psychiatrist, and Ill be let out within a day or two.

  69. Explain to them that according to Godel, it’ll be impossible for me to prove my true identity in a system where subjects can only be either psychiatrists or patients.

  70. I would simply ask the doctors to re-evaluate my need for any treatment. Since I’m perfectly healthy they would soon find out the real nature of things…

  71. At first I would ask the other psychiatrists if there was some method of separating “those who are or should be patients” from “those who are psychiatrists” beyond a reasonable doubt.

    If there was, I would ask them to use that method to evaluate me (as well as themselves, for comparison) in a transparent manner, and — assuming my belief isn’t delusional — and that the method, as well as the other psychiatrists are reasonable and honest, I would pass.

    If there weren’t such a method, it logically follows that we could all be patients and/or doctors at any given time, and that the arbitrary nature of that system would make it very dubious, if not unusable.

    If, however, the method was both reasonable and used in a seemingly correct fashion, yet still categorizing me as a patient, I would have to accept that outcome and use it as a working hypothesis for the time being.

    (Or I could just show them my student loans.)

  72. (I jumped down here after the first dozen or two replies, so I may have missed someone else saying the same thing.)
    No, curing other patients won’t “prove” that you really aren’t one.
    Back in the day I knew a guy who had done plenty of acid who happened to get a job as an orderly in the state nut house. They put him in the incurable psychotics ward, where he had no interpersonal trouble.
    But when patients finally asked,
    “How come you’re out there and I’m in here?” and he answered, “I just don’t talk about it as much,” he ended up getting fired because orderlies aren’t allowed to cure the incurable psychotics.

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