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ON BEING SANE IN INSANE PLACES

06-03-2007

Last week, Angela and Ian Gay from Halesowen were finally cleared of murdering Christian Blewitt, the little boy they had hoped to adopt. Dr Mike Drayton, a Birmingham psychologist examines how so many experts could have got it wrong.

The Gay's endured four-year legal battle, twice stood trial and spent 15 months in jail before a jury finally believed they did not kill three-year old; the case is one of the worst miscarriages of justice for infanticide since the wrongful imprisonment of Angela Cannings and Sally Clark.

Social workers, police and medical experts accused Mr and Mrs Gay of forcing Christian to eat four teaspoons of salt as a punishment.

After the first trial, when they were convicted of manslaughter, it emerged that Christian may have had a rare medical condition which allows sodium to build up in the body. Following this disclosure, the Court of Appeal ruled their convictions were unsafe and they were released on bail before facing the torment of a re-trial.

When they were tried again in Nottingham, new medical evidence was presented in court. And it took a jury seven hours to clear them after the six-week trial.

I only know what I've read about the case in the media but I was struck by the question how could all these people - these experts - have got it so wrong? How can these troupes of experienced social workers, medical experts, police and lawyers have made such a dreadful mistake? Not only wrong in the case of the Gays but in other similar cases like Angela Canning and Sally Clarke?

One factor that played its role is the psychological process called cognitive distortion. This means that when you have a predisposition to see something, you can ignore endless evidence to the contrary. And you can even imagine confirming evidence.

The Gay case reminded me of a piece of research published over thirty years ago by a psychologist called David Rosenhan. Although the topic of the research was very different I believe the underlying processes at play were similar. Rosenhan wanted to answer the question: If sanity and madness exist, can we tell them apart?

His research had two parts. In the first study, eight of his associates, who were perfectly sane presented themselves at different psychiatric hospitals feigning symptoms of hearing voices in an attempt to get admitted. Indeed all eight were admitted and given a diagnosis of schizophrenia. As soon as these pseudopatients became patients they dropped the pretence and started to behave perfectly normally.

What happened next was very interesting. All their ‘normal' behaviour began being interpreted by the staff as being evidence of their mental illness. Ordinary sane behaviour was overlooked or misinterpreted to fit in with the belief that they were ill. Minor disagreements became deep-seated indicators of emotional instability. Boredom was interpreted as anxiety.

Despite the fact that they did nothing out of the ordinary, the pseudopatients remained hospitalized for an average of 19 days, from a low of 9 days to a high of 52. Their sanity was never detected except, ironically enough, by the actual patients in the hospitals. They were eventually discharged, not as being sane or cured, but with the diagnosis of schizophrenia in remission.

For the second part of the research, Rosenhan contacted a large teaching hospital, whose staff were told about the above results but believed such errors could not be made by them. Rosenhan said that during a three month period, he would send along some pseudopatients to attempt to gain admission. During the three months a total of 193 patients were referred for admission. Out of these the psychiatric staff identified 41 as impostors and a further 42 were considered suspect.

In reality, Rosenhan hadn't sent any pseudopatients and all patients identified as impostors by the hospital staff were in fact genuine patients.

Rosenhan said that this evidence did not at all suggest that the hospital staff were in any way foolish, incompetent or dishonest. They were doing their jobs effectively.

He made the crucial point that there was no conscious effort to misinterpret the evidence to fit the label. Rather, Rosenhan argued that the labels were so powerful that they profoundly affected the way information was processed and perceived. Had the same behaviours been observed in a different context, they no doubt would have been interpreted in an entirely different fashion.

So, what has this got to do with the Gay's case? Well, I do wonder if the social workers, experts and police involved in the case acted rather like Rosenhan's psychiatrists in that once Angela and Ian Gay had been given the very powerful label of child murderer, then all the evidence that confirmed this was seized upon and all the evidence that contradicted the belief was unconsciously dismissed. Similarly, just like Rosenhan's pseudopatients, Angela and Ian Gay ended up being sane in an insane place.

Contact Dr Drayton at www.opuspsychology.com

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