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The Great Pretender by Susannah Cahalan
Narrative nonfiction

The Great Pretender

by Susannah Cahalan

Quick take

Rips back the curtain on mental health treatment. You'll be rightfully shaken, outraged, or both.

Good to know

  • Illustrated icon, Icon_HeavyRead

    Heavy read

  • Illustrated icon, Icon_400

    400+ pages

  • Illustrated icon, Icon_SocialIssues

    Social issues

  • Illustrated icon, Icon_Creepy


Illustrated icon, Icon_Challenging_Indicator


This book contains many scientific concepts and ideas, as well as themes of violence and abuse.

Why I love it

Maris Kreizman
Author, Slaughterhouse 90210

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 to her if her diagnosis of mental illness had stuck? This is what she grapples with in The Great Pretender, an engrossing history of the study of mental illness, centered around an experiment in which a psychiatrist and a group of other healthy people get themselves committed to mental hospitals in the early 1970s. There they experience the dehumanizing, traumatizing nature of the institutions themselves, and ultimately discover firsthand how mental illness diagnoses are biased and arbitrary at best.

How do we decide who is mentally ill? Drawing on years of archival research as well as her own personal experiences, Cahalan’s gripping account of the history of insanity is a feat of both enjoyable storytelling and skillful reporting.

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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 psychiatry's labels. Forced to remain inside until they'd "proven" themselves sane, all eight emerged with alarming diagnoses and even more troubling stories of their treatment. Rosenhan's watershed study broke open the field of psychiatry, closing down institutions and changing mental health diagnosis forever.

But, as Cahalan's explosive new research shows, very little in this saga is exactly as it seems. What really happened behind those closed asylum doors, and what does it mean for our understanding of mental illness today?

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Get an early look from the first pages of The Great Pretender.

Member thoughts

All (4735)
All (4735)
Love (1230)
Like (2500)
Dislike (1005)
5100 ratings
  • 24% Love
  • 49% Like
  • 20% Dislike
  • New York , NY

    The book is at its best when it’s about the study itself, which is roughly 65% of it? The remaining, despite being interesting, informative & incredibly infuriating, isn’t as “thrilling” of a read.

  • Bethesda, MD

    This was an eye—opening look at the way mental health care has been shaped over the years, and how difficult it can be for people to find the help they need. I enjoued the author’s thorough research

  • Dyersburg, TN

    I’m not sure what I expected, but this was very different. This book had me captivated from the beginning, however, it did take me a little longer to read than normal. I wanted to research everything!

  • Knightdale, NC

    About the history of psychiatry, I could not put this one down. I’d recommend to anyone who has personally, or seen someone, battle mental illness and to those who don’t understand mental illness.

  • Westminster , CO

    WOW. As a mentally ill woman with lots of mentally ill loved ones, this really hit home. This should be required reading for anyone who’s been involved in or affected by the inadequacy of psychiatry.

  • poquoson, VA

    After reading Susannah’s amazing book “brain on fire” i was looking forward to delving even further into the world of mental health. She did not disappoint. This is well researched . ❤️❤️

  • Summerville, SC

    If you or someone you know suffers from a mental illness, I encourage you to pick up this book. Take your time to read it. Soak up the knowledge. Think about what you’ve read. It’s a game-changer.

  • Portland, OR

    Excellent book! Interested in it bc my grandfather was committed after striking my grandmother in an angry moment. He was in his 70s and in the early 1950s. He had dementia but treatment was unknown.

  • Auburn, WA

    Incredible look at author of a study that began the shut down of state run Asylums & helped frame the DSM. Very readable, even through all medical terms. Right or wrong, what she reveals is fascinatng

  • University Hts , OH

    This is a thought provoking look at the mental health industry and has presented a history of the standards for diagnoses that are still in place today. Parts of the book read like a detective novel.

  • Brooklyn, NY

    The Great Pretender excels at creating doubt around what we believe to know about our treatment of mental illness in America. If you have any interest in social issues or mental health, this is a must

  • Dallas , TX

    An interesting and compeling look into the stigma against illness of the mind and how our healthcare system fails. I have family experience with misdiagnosis so felt especially connected to this story


    As someone who also struggled with a ‘pretender’ illness, this book hit close to home. It was well written, and did a great job at showing the evidence and assumptions led to the conclusions drawn

  • Puyallup, WA

    This book is the reason I subscribe to BOTM. If you're interested in psychology or medicine in general you will read this book in 2 hours like I did. Read Brain on Fire too (same author)! I'm obsessed

  • Doral, FL

    Why are mental illnesses treated so differently from physiological ones? I loved this book it was a wild ride and made me think of mental illness and the way we treat patients differently. must read!

  • las cruces, NM

    Pretty great journalism on the sordid history of diagnosis and treatment in psychology. Sometimes the author is a bit indulgent for my taste,but the book can be quite entertaining and is informative!!

  • Jenkintown , PA

    As someone with a background in science, some of the revelations about this study, especially since it has been sooo influential in the care of so many in the last almost half a century, were jarring.

  • San Antonio , TX

    This book is amazing. There is not enough research on the mysteries of mental illness. We are still discovering how best to treat those impacted. This important topic needs more main stream visibility

  • Mesa, AZ

    I've suffered with mental disabilities all my life and this book just helps draw so much attention to these issues. It's hard to describe what we go through. But even today, we don't get the best help

  • New York, NY

    This book was more terrifying than any mystery-thriller novel I've ever picked up. Reading it, I was reminded of how little we understand about the human brain and what the repercussions of that are.

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