sanity vs insanity

How do we define sanity? How about insanity?

Psychology defines insanity as any maladaptive pattern of behaviour which disrupts a person's way of life, deviates from the norm, and causes significant distress.

By those measures, an otherwise "normal" person who undergoes a depressive episode due to a traumatic incident, say, a divorce, is insane. He's always late for work; "normal" people do not cry themselves to sleep; and clearly, he is distressed.

By those same measures, if a person with undiagnosed schizoaffective disorder can maintain employment, and not be overly distubed by-- or even find happiness-- in their delusions, is considered sane.

So, what is insanity?

Insanity has been treated as a cut-off point beyond which the person is deemed "crazy." Everything up to that cut-off point--that crucial diagnostic criterion--is grey area; we watch that person carefully for signs that they are about to go one of two ways.

The other extreme is the elusive concept of "norm" or "typicality." Sanity, even.

There are several problems with this view.

1) Our concept of "normal" behaviour stems from norms. These are measured by artificial, empirical methods from a select sampling, and are then generalized to the entire population. "Normal" means "average." "Average" means "being intermediate between extremes, as on a scale."

2) In layperson terms, "average" means "ordinary." However, our concepts of what is "ordinary" change as our experiences change. Suddenly, "normal" doesn't seem so concrete.

3) Back to the intermediate between extremes: the average is supposed to be a happy median, a resting point between total absence of a given target, in this case, a behaviour; and an excess of a behaviour to the point where it becomes problematic.

4) It is clear that there is a scale implied. However... it's not defined! If "normal" behaviour lies in the middle of a scale, what lies on either side of it? It is easy to assume that on one side, we have insanity. What about the other side? If "average" is in the middle, then it's not the end of the spectrum, now is it. There is something else. Is it "total sanity?"

5) By those measures, "normal" lying in the middle of the scale, the "norm" is that everyone is halfway to the looney bin.

6) By those same measures, "total sanity" is abnormal. It deviates from the norm. It is... insane?

This is an exaggerated and ridiculous example, but I think it illustrates the point--psychology is currently rife with circular thinking.

There is a spectrum for the severity of a flu. Bob's had a 40 degree Celsius fever for three days. Mary has an itchy throat and a slight 24-hour fever. There is a spectrum for personality traits. One person has road rage more often--and more vocally--than another. Similarly, mental illnesses vary on spectrums of severity. This patient has depression, and is more depressed than another patient. Similarly, people's overall states of mind--if they can even be lumped together as such--vary on a spectrum.

I am more prone to delusional thinking than you. You have less control over your fear than I do. I am less delusional than a person diagnosed with dissociative identity disorder. You are more "phobic" of spiders than a person who is declared unafraid of bugs of any kind.

We all possess some behavioural, personality, or cognitive tendencies to some degree. At what point do these behaviours become so extreme that they are diagnosable as illnesses or disorders?

Therein lies the problem. Diagnostic criteria set out to outline rules for measuring and analyzing a person's behaviours to determine whether they are extreme enough. When these extreme behaviours occur together in a certain way, they qualify as a certain condition.

The confusion sets in partly when it becomes clear that diagnostic criteria are fluid concepts which evolve frequently. This is because they are human constructs. They are based on mathematical averages, which are prone to skew, misrepresentation, and biases due to a pursuit of linearity.

That is, even with operationally defined concepts of mental illness, disagreements abound on the importance or even necessity of any given criterion.

People are PEOPLE. They all possess certain traits to any given degree--it's important to remember that.

Linearity is not the end-all, be-all solution to predicting behaviour. Just look at chaos theory.