On self-analysis and the meaning of sanity

How does one know if he is insane? I used to joke that the main symptom of insanity was insisting on one’s own sanity—it turns out that psychiatrists don’t disagree. Traditionally, “insight” into one’s own mental illness is considered an important step on the way to recovery. Regardless of the merits and flaws of this view, there obviously have to be other markers (unless we want to conclude that the only truly sane people are those who admit their insanity); whether its effects are helpful or detrimental, insight does not erase a disorder.

(Note, here, I will avoid politically correct terms such as “mental illness” for multiple reasons.  The root causes of different disorders remain unknown; additionally, it is unclear if “mental illness” includes “temporary insanity” or mind disturbances associated with an identifiably physical illness, such as the delirium of fever).

So how do we distinguish a “sane” from a disordered mind? It seems the answer is so difficult to identify that we may begin to question whether “sanity” as a concept is meaningful.

Even well-defined symptoms like hallucinations occur in the “healthy” population—occasionally to a greater extent than those associated with psychosis. Other symptoms are even more vague, harder to define. When does introversion become indicative of depression? Where does a “good mood” fall on the spectrum from mere cheerfulness to full-blown mania?

Some psychologists only consider a trait pathological if it significantly affects the sufferer’s ability to function. But here too, the line between normal and impaired function is often blurred. Everyone has different coping mechanisms—likely some work better than others; some are more societally acceptable, whereas others carry stigma. One person may reach for a cigarette, another for a razor blade. Which of the two has the “greater ability to function”? Should we base diagnosis on the shape of someone’s crutch?

And what about self-analysis? How useful is it really to dissect one’s own feelings and reactions, to scrutinize the mind? Perhaps if we suspect that our excitement and restlessness might be symptomatic of hypomania, we may be more careful to ensure that our actions arise from rational decision-making, rather than from impulse. On the other hand, why waste the excess energy self-analyzing? If the urge to paint strikes in the middle of a sleepless night, why brush it off as a symptom of disorder, when you can just do it.insanity

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One Response to On self-analysis and the meaning of sanity

  1. jjhiii24 says:

    You correctly point out the vagaries of what constitutes “sanity,” and ask some vitally important questions about how we should view each other, relative to our ability to function and still be dealing with some form of mental illness. Your own reference to your personal stress levels during university attendance in “Keeping Myself Sane,” speaks directly to the dilemma. Even people who suffer from what might be described as debilitating psychoses can be reasonably managed with treatment and medication, and many of us endure periods of elevated stress with “crutches” of every sort, and are not considered to be “insane.”

    The classical view of insanity as being completely out of touch with “reality,” defined I suppose by severe symptoms and an inability to regain control of thoughts and behaviors by any traditional medicinal or psychological treatment, really only identifies the extreme end of the spectrum of mental illness. Judging someone to be insane with varying degrees of lesser difficulty in this regard becomes problematical, although particular signposts are generally applied as being indicative of some particular pathology, especially with our advancing understanding of brain chemistry and physiology.

    It seems to me that the application of the word, “insane,” is, as you suggested, probably no longer meaningful as a general term, since only the most extreme cases make the term useful. Identifying pathologies and brain disorders and behavioral issues related to severe stress as we are able to isolate them in treatment seems a better approach. Your interesting musings seem to indicate a fairly balanced view in the main, and are refreshingly candid and thoughtful.

    It’s great to read some new postings here and I hope you will continue to share them as you progress in your understanding.

    Kind regards…..John H.

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