Saturday, June 9, 2012

What is "Sanity"? Why Accept Our Definition of it?

Is the definition of sanity arbitrary or independent of societal opinions of what a person ought to be?

For example, if everyone alive barring you thought they had the spirit of the Archangel Gabriel within them, what right would you have to call yourself sane and others insane? The Soviets declared 'anti-Socialist' behavior a mental disorder. What gives us the right to condemn the USSR for such practices? What's the difference between the Soviet practice and our usual practice of considering someone possessed of Gabriel insane?

Also, is having any mental disorder enough to keep you from having sound mind and will"? Also, what constitutes a sound mind and will, and what criteria do you use to determine it?"

The wikipedia entry, IMO, is a fairly good starting point. Basically it says that the scientific method can shed light of what is meant by sanity independent of societal perceptions

From Wikipedia: Sanity 

 From Sanity (wikipedia entry)

A theory of sanity was proposed by Alfred Korzybski in his general semantics. He believed that sanity was tied to the structural fit or lack of it between our reactions to the world and what is actually going on in the world. He expressed this notion in a map-territory analogy: "A map is not the territory it represents, but, if correct, it has a "similar structure" to the territory, which accounts for its usefulness."[1] Given that science continually seeks to adjust its theories structurally to fit the facts, i.e., adjusts its maps to fit the territory, and thus advances more rapidly than any other field, he believed that the key to understanding sanity would be found in the study of the methods of science (and the study of structure as revealed by science). The adoption of a scientific outlook and attitude of continual adjustment by the individual toward his or her assumptions was the way, so he claimed. In other words, there were "factors of sanity to be found in the physico-mathematical methods of science."

Psychiatrist Philip S. Graven suggested the term "un-sane" to describe a condition that is not exactly insane, but not quite sane either.[2]

In The Sane Society, published in 1955, psychologist Erich Fromm proposed that, not just individuals, but entire societies "may be lacking in sanity". Fromm argued that one of the most deceptive features of social life involves "consensual validation."[3]:

“ It is naively assumed that the fact that the majority of people share certain ideas or feelings proves the validity of these ideas and feelings. Nothing is further from the truth... Just as there is a folie à deux there is a folie à millions. The fact that millions of people share the same vices does not make these vices virtues, the fact that they share so many errors does not make the errors to be truths, and the fact that millions of people share the same form of mental pathology does not make these people sane.[4] 

And then there's Michel Foucalt

 Genre History (299 pp.)

Keywords Communication, Cross-Cultural Issues, Doctor-Patient Relationship, Freedom, History of Medicine, History of Science, Hospitalization, Hysteria, Institutionalization, Law and Medicine, Literary Theory, Medical Advances, Mental Illness, Poverty, Power Relations, Psychiatry, Psychotherapy, Public Health, Society


A severe synopsis of Foucault's first major work might show how Foucault charts the journey of the mad from liberty and discourse to confinement and silence and how this is signposted by the exercise of power. He starts in the epoch when madness was an "undifferentiated experience" (ix), a time when the mad roamed the countryside in "an easy wandering existence" (8); Foucault shows the historical and cultural developments that lead to "that other form of madness, by which men, in an act of sovereign reason, confine their neighbors" (ix), challenging the optimism of William Tuke and Phillipe Pinel's "liberation" of the mad and problematizing the genesis of psychiatry, a "monologue of reason about madness" (xi).

Central to this is the notion of confinement as a meaningful exercise. Foucault's history explains how the mad came first to be confined; how they became identified as confined due to moral and economic factors that determined those who ought to be confined; how they became perceived as dangerous through their confinement, partly by way of atavistic identification with the lepers whose place they had come to occupy; how they were "liberated" by Pinel and Tuke, but in their liberation remained confined, both physically in asylums and in the designation of being mad; and how this confinement subsequently became enacted in the figure of the psychiatrist, whose practice is "a certain moral tactic contemporary with the end of the eighteenth century, preserved in the rites of the asylum life, and overlaid by the myths of positivism." Science and medicine, notably, come in at the later stages, as practices "elaborated once this division" between the mad and the sane has been made (ix).


This history is one of Foucault's most fascinating explorations of the relationship between knowledge and power. It would be simplistic to say that an exercise of power is then justified by a body of knowledge which forgets how it is related to that exercise of power, but that is one message that can be derived from Foucault's project here: the role of discourses, imaginary figures, political and economic developments, all play a role in organizing the relationships between people, power, and knowledge.

Says Foucault: "the essential thing is that the enterprise did not proceed from observation to the construction of explanatory images; that on the contrary, the images assured the initial role of synthesis, that their organizing force made possible a structure of perception, in which at last the symptoms could attain their significant value and be organized as the visible presence of truth" (135). This could be a criticism of psychiatry, of science, or of Foucault's project itself.

The book provides a deeply challenging portrait of madness and, Foucault argues, the loss of madness as a voice in dialogue with reason: although many psychologists, psychiatrists and psychoanalysts may argue that the analyst's couch (or chair, etc) has allowed this voice to return, they might want to consider Foucault's provocative arguments to the contrary, that the Freudian development of therapeutic listening was, though a return of sorts to listening to madness, nevertheless undertaken under such circumstances and in such a relationship that it "can unravel some of the forms of madness [but] it remains a stranger to the sovereign enterprise of unreason. It can neither liberate nor transcribe, nor most certainly explain, what is essential in this enterprise" (278).

As he will do in Birth of the Clinic, Foucault watches men describe other men and women, and sees how their observations begin to take a shape recognizable to us today: but this is not "because in the course of centuries we have learned 'to open our eyes' to real symptoms; it is not because we have purified our perception to the point of transparency: it is because in the experience of madness, these concepts were organized around certain qualitative themes that lent them their unity, gave them their significant coherence, made them finally perceptible" (130). This is a challenging book for psychologists, psychiatrists, and other physicians, and is a gauntlet thrown that few have chosen to take up.

Publisher Random House

Edition 1988 (Vintage)
Place Published New York
Miscellaneous First Published in the United States by Pantheon Books in 1965, and in France as Histoire de la Folie in 1961 by Librarie Plon 

Maybe I’m misreading Foucalt, but it sounds like he’s asserting that “sanity” is enforcement of societal and/or elite expectations of what a person ought to be and/or assumptions of what “proper mental health” is, then misusing the scientific method to define what sanity is – namely by assuming the societal and/or elite definitions are the only proper foundation on which to build, then building psychiatry’s whole superstructure on that foundation.

From another angle, there seems to be both arbitrary and objective definitions of sanity, which I find agreeable. In fact, sanity seems to be more of a legal term than a scientific one. Still, to repeat what I said earlier,  I think the scientific method of discerning the truth of a situation is a pretty objective standard. What that means is that if a person uses the scientific method to interpret the facts he or she comes across, and they are independently confirmable, then that signals a sound mind.

Even within the scientific method, we still have to ask how many gross mistakes in perception and interpretation they make. If you ask me, a good general rule is this: the more simple the fact or relationship, the more a gross error in perception or judgment will count towards insanity. For example, claiming you are, in fact, the POTUS when you clearly are not definitely counts for insanity. If you say you have a good chance to be POTUS when you clearly have little to no chance of getting elected, then you may close to the edge. On the other hand, if a highly ambitious politician thinks to him or herself  "I deserve to sit in the Oval Office because I'm more right than POTUS is and therefore can administer the country better", we probably won't consider the politician insane - although we'd consider him or her an egotistical fool. However, the best litmus tests I can think of are:

(a) whether their cognitive processes and self-awareness of who they are are strikingly out of touch with reality, and
(b) the degree of emotional control or self-discipline they have in interpersonal interactions (i.e. no consistent history of emotional reactions common knowledge says are well outside the boundaries of legal behavior).

Of these, I think (a) is more important, although no violations of (a) and several violations of (b) are are at least fairly likely symptomatic of a personality disorder (an entirely separate category from insanity).

Nevertheless, I find it difficult to disagree that one of society's eternal dangers concerning individual freedom and dignity concerns developing too broad or too narrow a definition of sanity - namely "behavior highly outside the norm". Some definitions would cover some of the greatest authors, writers, musicians, artists, etc. (although greatness itself doesn't not immunize one from insanity).

In the end, the definition of sanity can't help but be at least partially arbitrary, especially for the qualitative traits (as opposed to quantitative ones).  Even so, I think that any definition of sanity must start from how a person's mind processes objective (i.e. falsifiable and confirmable) facts and data about reality. Certainly this is more important than the definition based on collective society's mere say-so.

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