Line between Sane and Insane

[Yoseph]

I was thinking the other day about this, specifically what makes someone insane rather than just habitually weird. Take for example a man who dresses up in a scary clown suit and sits in a park perhaps, from his perspective he is attention seeking and is amused by the way people react to seeing him, to anyone else he seems to be insane. That is just the first example I can think of, but I see lots of strange looking/acting people who have weird habits (and I imagine philosphies), but where is the line between someone who's a "weirdo" and someone who is insane? When does your view of the world become so different from everyone elses that you should be labelled insane? Why is your perspective considered insane when it is just a culmination of all your past experiences, why the perspective "wrong"?

[thinker_jeff]

This question may lead more philosphical discussions.

I think that it has strong relation with the motivation of the person.

If you intentionally want to make yourself looking more unique and better than others but the majority of people see you weird, that means you made a mistake (may or may not be insane).

If you have no intention to act special but the majority see you weird, you are probably insane.

When you intentionally act weird to amuse others and the people are really amused, you are sane and doing great.

Edited September 9, 2011 by thinker_jeff

[TonyMcC]

I think everybody in the world except you and me are at least a little mad - and I'm not too sure about you!

[Phi for All]

The difference is perceptual, and may vary between societies. In the US we may judge a person insane if they suddenly leave their job and family to wander around in the desert, but aboriginal Australians call that "walkabout" and consider it a perfectly sane rite of passage. In the end, I suppose we judge the difference by how much of a danger one is to oneself or others.

 

The actual "line" between sanity and insanity is a purple one, painstakingly woven from lint I found stuck to some tape that held my copy of Animal Farm together, and carefully dyed with a Sharpie marker my aunt Dorothy gave me for Christmas in 1969.

[PhDwannabe]

I was thinking the other day about this, specifically what makes someone insane rather than just habitually weird. Take for example a man who dresses up in a scary clown suit and sits in a park perhaps, from his perspective he is attention seeking and is amused by the way people react to seeing him, to anyone else he seems to be insane. That is just the first example I can think of, but I see lots of strange looking/acting people who have weird habits (and I imagine philosphies), but where is the line between someone who's a "weirdo" and someone who is insane? When does your view of the world become so different from everyone elses that you should be labelled insane? Why is your perspective considered insane when it is just a culmination of all your past experiences, why the perspective "wrong"?

 

The use of the word "insane" is really not the most helpful here, since, given your elaboration of your questions, it goes a little ways towards conflating two different concepts: when is a person mentally ill, and when is a person psychotic?

 

The question of how to define mental illness invites all sorts of armchair philosophizing, usually about how all of those damned doctors just want to label everyone with a disease. This argument usually has kind of a quasi-libertarian, anti-authoritarian tone to it, and often gets political--people have a sense that the Man is keeping the people down with his disease labels (c.f. Szasz, Thomas). Sometimes people have a sort of fundamental discomfort with the idea of being labeled (to which I usually say, sorry dude, to think is to categorize. You can be described--imperfectly, but usefully--categorically along abut a million different domains. Get used to it.) I find this sort of argument pretty profoundly irritating, as I think it throws the mental health baby out with the admittedly irritating drug company nonsense bathwater. Do some people have a vested interest in perhaps increasing the number of individuals who might be diagnosable with a mental illness? Yes. Drug companies do. Does that make it some enormous conspiracy, and does that make mental illness a myth? No. It just makes some of the edges of some of the categories, and in particular, the way they're often "diagnosed" in practice, if you can even call it that, problematic. These issues are really complex and nuanced. They don't lend themselves to rhetorical sledgehammers.

 

So, getting to your question--or, what I see as the first half of it--what makes someone mentally ill? Again, tough as hell to answer, but I can give you the three D's: deviance, distress, and danger. Essentially: is this behavior really abnormal, given the context? Does it really subjectively bother the person? Is there a risk of harm? There's no exacting formula here; we can think of all sorts of marginal cases. Suppose we meet a guy who shows a lot of really depressive behavior--laying around in his bedroom, not bathing or sleeping or eating normally--and in addition, he expresses suicidal thoughts and plans, but for some reason, he claims not to be bothered by any of this. Two D's but not the other. Mentally ill? Yeah, he probably still is. These three constructs themselves are dimensional, not categorical. There isn't a bright line.

 

Now, what makes someone psychotic? It's a little easier here, but still not perfect. Psychoticism is really all about a disruption of normal cognition or perception that isn't better-explained by other things. (This is why hallucinations experienced just before sleep onset, or while under the influence of drugs, "don't count" for the diagnostic criteria.) So, does the guy you describe above believe bizarre things that are contrary to the commonsense ways that we're aware the universe works? For instance, does he think that people might die if he doesn't dress up in his clown outfit every day? Or does he have perceptual experiences unusual to normal humans in a normal state: is he hearing things, seeing things that aren't there? If he's not exhibiting these symptoms, well, he's really not psychotic. That doesn't mean that he isn't really weird. Again, these criteria are not perfectly specified. How weird does a belief have to be in order to qualify as delusional, for instance? The belief that a man in a robe actually turns bread into flesh every Sunday morning might seem to be pretty odd--and indeed, it might have as much force of reason behind it as any tinfoil-hat fantasy--but it's rendered less weird by the fact that billions of people think so. It might be an unsatisfying way to define it--and again, this says nothing about its veracity--but that belief isn't delusional largely because plenty of nondelusional people hold it. The lines are brighter here than the three D's, but it can still take a skilled clinician to puzzle out some of the more marginal cases.

 

Your guy's not insane. Needs a shrink, though.

[Phi for All]

Your guy's not insane. Needs a shrink, though.

On which side of the line is THIS guy? It's unfortunate that we're not equipped to help someone like this. This isn't his first post and threads we leave open get filled with pleas that he seek psychiatric help, which he's convinced he doesn't need.

 

I reserve the right to delete any posts after this one. I'm not entirely comfortable discussing another member in an open section, but I just feel so bad for this guy that I needed some input. Let's keep any comments professional, please.

Edited September 18, 2011 by Phi for All
link disabled

[PhDwannabe]

On which side of the line is THIS guy? It's unfortunate that we're not equipped to help someone like this. This isn't his first post and threads we leave open get filled with pleas that he seek psychiatric help, which he's convinced he doesn't need.

 

I have ethical and professional mandates not to "diagnose at a distance," so that's a discussion I'm out of, and would furthermore encourage others to refrain from out of general good taste.

[Phi for All]

I have ethical and professional mandates not to "diagnose at a distance," so that's a discussion I'm out of, and would furthermore encourage others to refrain from out of general good taste.

Good call, and it helped me decide. Links removed; continue with the discussion in the OP.

[ccdan]

I have ethical and professional mandates not to "diagnose at a distance," so that's a discussion I'm out of, and would furthermore encourage others to refrain from out of general good taste.

You're being dishonest... you should admit openly that you can't diagnose anything (from a distance or not), simply because there's no objective, verifiable and scientific criteria for such a thing!

Everything in psychiatry and psychology is based on pseudoscience, subjectivity and imagination.

[PhDwannabe]

You're being dishonest... you should admit openly that you can't diagnose anything (from a distance or not), simply because there's no objective, verifiable and scientific criteria for such a thing!

Everything in psychiatry and psychology is based on pseudoscience, subjectivity and imagination.

 

By god, ccdan, your relentless (and always on-topic) trolling has finally shown me the light. I've just quit my doctoral program and am packing my belongings into my car as we speak.

[ccdan]

By god, ccdan, your relentless (and always on-topic) trolling has finally shown me the light. I've just quit my doctoral program and am packing my belongings into my car as we speak.

Oh! So... approaching this subject in an objective, rigorous and scientific manner (I guess you know my older posts) is called "trollig" ... interesting!

 

As, for your "doctoral program" it's not really a surprise... there are PhD's in "fields" like theology, philosophy and in some countries even in astrology... and who knows what else... apparently, if there are enough people preoccupied by certain "subjects" no matter how non-scientific and nonsensical, there could also be PhD programs for those things...

[mooeypoo]

!

Moderator Note

Enough. Personal attacks will not fly, no matter how much you think they're benefiting your argument (which is none at all), ccdan.
Debates are done in a civil manner or not at all here.

[ccdan]

@mooeypoo: I don't understand what you mean! and you seem to be extremely "selective" with your "observations".... the fact that PhDWannabe called me a "troll" for absolutely no reason, means nothing...

[mooeypoo]

@mooeypoo: I don't understand what you mean! and you seem to be extremely "selective" with your "observations".... the fact that PhDWannabe called me a "troll" for absolutely no reason, means nothing...

 

The first step of anything would be of you getting off the patronizing attitude and not argue with forum rules. He didn't call you a troll, he said you're trolling, which is an interesting observation that might or might not be true.

 

Go back on topic and do not make things worse by arguing the rules you agreed to when you signed up to this forum.