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Insanity, madness, lunacy, and craziness are
behavior Behavior (American English) or behaviour (British English) is the range of actions and mannerisms made by individuals, organisms, systems or artificial entities in some environment. These systems can include other systems or organisms as wel ...
s performed by certain abnormal mental or behavioral patterns. Insanity can be manifest as violations of
societal norms Social norms are shared standards of acceptance, acceptable behavior by groups. Social norms can both be informal understandings that govern the behavior of members of a society, as well as be codified into wikt:rule, rules and laws. Social normat ...
, including a person or persons becoming a danger to themselves or to other people. Conceptually, mental insanity also is associated with the biological phenomenon of contagion (that mental illness is infectious) as in the case of
copycat suicide A copycat suicide is defined as an emulation of another suicide that the person attempting suicide knows about either from local knowledge or due to accounts or depictions of the original suicide on television and in other media. The publicized ...
s. In contemporary usage, the term ''insanity'' is an informal, un-scientific term denoting "mental instability"; thus, the term
insanity defense The insanity defense, also known as the mental disorder defense, is an affirmative defense by excuse in a criminal case, arguing that the defendant is not responsible for their actions due to an episodic psychiatric disease at the time of the cr ...
is the legal definition of mental instability. In medicine, the general term
psychosis Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior ...
is used to include the presence either of
delusions A delusion is a false fixed belief that is not amenable to change in light of conflicting evidence. As a pathology, it is distinct from a belief based on false or incomplete information, confabulation, dogma, illusion, hallucination, or some o ...
or of
hallucinations A hallucination is a perception in the absence of an external stimulus that has the qualities of a real perception. Hallucinations are vivid, substantial, and are perceived to be located in external objective space. Hallucination is a combinatio ...
or both in a patient; and psychiatric illness is "
psychopathology Psychopathology is the study of abnormal cognition, behaviour, and experiences which differs according to social norms and rests upon a number of constructs that are deemed to be the social norm at any particular era. Biological psychopatholo ...
", not ''mental insanity''. An interview with Dr. Joseph Merlino, David Shankbone, ''
Wikinews Wikinews is a free-content news wiki and a project of the Wikimedia Foundation that works through collaborative journalism. Wikipedia cofounder Jimmy Wales has distinguished Wikinews from Wikipedia by saying, "On Wikinews, each story is to be ...
'', 5 October 2007.
In
English English usually refers to: * English language * English people English may also refer to: Peoples, culture, and language * ''English'', an adjective for something of, from, or related to England ** English national ide ...
, the word "sane" derives from the
Latin Latin (, or , ) is a classical language belonging to the Italic branch of the Indo-European languages. Latin was originally a dialect spoken in the lower Tiber area (then known as Latium) around present-day Rome, but through the power of the ...
adjective ''sanus'' meaning "healthy".
Juvenal Decimus Junius Juvenalis (), known in English as Juvenal ( ), was a Roman poet active in the late first and early second century CE. He is the author of the collection of satirical poems known as the ''Satires''. The details of Juvenal's life ...
's phrase ''
mens sana in corpore sano ''Mens sana in corpore sano'' () is a Latin phrase, usually translated as "a healthy mind in a healthy body". The phrase is widely used in sporting and educational contexts to express that physical exercise is an important or essential part of men ...
'' is often translated to mean a "healthy mind in a healthy body". From this perspective, insanity can be considered as poor health of the mind, not necessarily of the brain as an organ (although that can affect mental health), but rather refers to defective function of mental processes such as reasoning. Another Latin phrase related to our current concept of sanity is "
compos mentis A number of Latin terms are used in legal terminology and legal maxims. This is a partial list of these terms, which are wholly or substantially drawn from Latin. __TOC__ Common law Civil law Ecclesiastical law See also * B ...
" (lit. "sound of mind"), and a euphemistic term for insanity is "non compos mentis". In law,
mens rea In criminal law, (; Law Latin for "guilty mind") is the mental element of a person's intention to commit a crime; or knowledge that one's action (or lack of action) would cause a crime to be committed. It is considered a necessary element ...
means having had criminal intent, or a guilty mind, when the act (
actus reus (), sometimes called the external element or the objective element of a crime, is the Law Latin term for the "guilty act" which, when proved beyond a reasonable doubt in combination with the ("guilty mind"), produces criminal liability in th ...
) was committed. A more informal use of the term insanity is to denote something or someone considered highly unique, passionate or extreme, including in a positive sense. The term may also be used as an attempt to discredit or criticize particular ideas, beliefs, principles, desires, personal feelings, attitudes, or their proponents, such as in politics and religion.


Historical views and treatment

Madness, the non-legal word for insanity, has been recognized throughout history in every known society. Some traditional cultures have turned to witch doctors or shamans to apply magic, herbal mixtures, or folk medicine to rid deranged persons of evil spirits or bizarre behavior, for example. Archaeologists have unearthed skulls (at least 7000 years old) that have small, round holes bored in them using flint tools. It has been conjectured that the subjects may have been thought to have been possessed by spirits which the holes would allow to escape. More recent research on the historical practice of
trepanning Trepanning, also known as trepanation, trephination, trephining or making a burr hole (the verb ''trepan'' derives from Old French from Medieval Latin from Greek , literally "borer, auger"), is a surgical intervention in which a hole is drill ...
supports the hypothesis that this procedure was medical in nature and intended as means of treating cranial trauma.


Ancient Greece

The
Greeks The Greeks or Hellenes (; el, Έλληνες, ''Éllines'' ) are an ethnic group and nation indigenous to the Eastern Mediterranean and the Black Sea regions, namely Greece, Cyprus, Albania, Italy, Turkey, Egypt, and, to a lesser extent, oth ...
appeared to share something of the modern Western world's secular and holistic view, believing that afflictions of the mind did not differ from diseases of the body. Moreover, they saw mental and physical illness as a result of natural causes and an imbalance in bodily humors.
Hippocrates Hippocrates of Kos (; grc-gre, Ἱπποκράτης ὁ Κῷος, Hippokrátēs ho Kôios; ), also known as Hippocrates II, was a Greek physician of the classical period who is considered one of the most outstanding figures in the history of ...
frequently wrote that an excess of black bile resulted in irrational thinking and behavior.


Ancient Rome

Romans made other contributions to psychiatry, in particular a precursor of some contemporary practice. They put forward the idea that strong emotions could lead to bodily ailments, the basis of today's theory of
psychosomatic A somatic symptom disorder, formerly known as a somatoform disorder,(2013)

From the Middle Ages onward

The
Middle Ages In the history of Europe, the Middle Ages or medieval period lasted approximately from the late 5th to the late 15th centuries, similar to the post-classical period of global history. It began with the fall of the Western Roman Empire a ...
witnessed the end of the progressive ideas of the Greeks and Romans. During the 18th century, the French and the British introduced humane treatment of the clinically insane, though the criteria for diagnosis and placement in an asylum were considerably looser than today, often including such conditions as
speech disorder Speech disorders or speech impairments are a type of communication disorder in which normal speech is disrupted. This can mean stuttering, lisps, etc. Someone who is unable to speak due to a speech disorder is considered mute. Speech skills ar ...
, speech impediments,
epilepsy Epilepsy is a group of non-communicable neurological disorders characterized by recurrent epileptic seizures. Epileptic seizures can vary from brief and nearly undetectable periods to long periods of vigorous shaking due to abnormal electrical ...
, and depression or being pregnant out of wedlock. Europe's oldest asylum was the precursor of today's
Bethlem Royal Hospital Bethlem Royal Hospital, also known as St Mary Bethlehem, Bethlehem Hospital and Bedlam, is a psychiatric hospital in London. Its famous history has inspired several horror books, films and TV series, most notably '' Bedlam'', a 1946 film with ...
in
London London is the capital and largest city of England and the United Kingdom, with a population of just under 9 million. It stands on the River Thames in south-east England at the head of a estuary down to the North Sea, and has been a majo ...
, known then as ''Bedlam'', which began admitting the mentally ill in 1403 and is mentioned in
Chaucer Geoffrey Chaucer (; – 25 October 1400) was an English poet, author, and civil servant best known for '' The Canterbury Tales''. He has been called the "father of English literature", or, alternatively, the "father of English poetry". He w ...
's ''
Canterbury Tales ''The Canterbury Tales'' ( enm, Tales of Caunterbury) is a collection of twenty-four stories that runs to over 17,000 lines written in Middle English by Geoffrey Chaucer between 1387 and 1400. It is widely regarded as Chaucer's ''magnum opus' ...
''. The first
American American(s) may refer to: * American, something of, from, or related to the United States of America, commonly known as the "United States" or "America" ** Americans, citizens and nationals of the United States of America ** American ancestry, pe ...
asylum was built in
Williamsburg, Virginia Williamsburg is an Independent city (United States), independent city in the Commonwealth (U.S. state), Commonwealth of Virginia. As of the 2020 United States census, 2020 census, it had a population of 15,425. Located on the Virginia Peninsula ...
, circa 1773. Before the 19th century these hospitals were used to isolate the mentally ill or the socially ostracized from society rather than cure them or maintain their health. Pictures from this era portrayed patients bound with rope or chains, often to beds or walls, or restrained in
straitjacket A straitjacket is a garment shaped like a jacket with long sleeves that surpass the tips of the wearer's fingers. Its most typical use is restraining people who may cause harm to themselves or others. Once the wearer slides their arms into the ...
s.


Medicine

Insanity is no longer considered a medical diagnosis but is a legal term in the United States, stemming from its original use in
common law In law, common law (also known as judicial precedent, judge-made law, or case law) is the body of law created by judges and similar quasi-judicial tribunals by virtue of being stated in written opinions."The common law is not a brooding omnipresen ...
. The disorders formerly encompassed by the term covered a wide range of
mental disorder A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitti ...
s now diagnosed as
bipolar disorder Bipolar disorder, previously known as manic depression, is a mental disorder characterized by periods of depression and periods of abnormally elevated mood that last from days to weeks each. If the elevated mood is severe or associated with ...
, organic brain syndromes,
schizophrenia Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social withdra ...
, and other psychotic disorders.


Law

In United States
criminal law Criminal law is the body of law that relates to crime. It prescribes conduct perceived as threatening, harmful, or otherwise endangering to the property, health, safety, and moral welfare of people inclusive of one's self. Most criminal law i ...
, insanity may serve as an affirmative defense to criminal acts and thus does not need to negate an element of the prosecution's case such as general or specific intent. Each U.S. state differs somewhat in its definition of insanity but most follow the guidelines of the Model Penal Code. All jurisdictions require a sanity evaluation to address the question first of whether or not the defendant has a mental illness. Most courts accept a major mental illness such as
psychosis Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior ...
but will not accept the diagnosis of a
personality disorder Personality disorders (PD) are a class of mental disorders characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating from those accepted by the individual's culture ...
for the purposes of an insanity defense. The second question is whether the mental illness interfered with the defendant's ability to distinguish right from wrong. That is, did the defendant know that the alleged behavior was against the law at the time the offense was committed. Additionally, some jurisdictions add the question of whether or not the defendant was in control of their behavior at the time of the offense. For example, if the defendant was compelled by some aspect of their mental illness to commit the illegal act, the defendant could be evaluated as not in control of their behavior at the time of the offense. The forensic mental health specialists submit their evaluations to the court. Since the question of sanity or insanity is a legal question and not a medical one, the judge and or jury will make the final decision regarding the defendant's status regarding an insanity defense. In most jurisdictions within the United States, if the insanity plea is accepted, the defendant is committed to a psychiatric institution for at least 60 days for further evaluation, and then reevaluated at least yearly after that. Insanity is generally no defense in a civil lawsuit, but an insane plaintiff can
toll Toll may refer to: Transportation * Toll (fee) a fee charged for the use of a road or waterway ** Road pricing, the modern practice of charging for road use ** Road toll (historic) The road toll was a historical fee charged to travellers and ...
the statute of limitations for filing a suit until gaining sanity, or until a
statute of repose A statute of repose (sometimes called a nonclaim statute), like a statute of limitations, is a statute that cuts off certain legal rights if they are not acted on by a specified deadline. Statutes of repose exist in a number of contexts. Some jur ...
has run.


Feigning

Feigned insanity is the simulation of mental illness in order to deceive. Amongst other purposes, insanity is feigned in order to avoid or lessen the consequences of a confrontation or conviction for an alleged crime. A number of treatises on medical jurisprudence were written during the nineteenth century, the most famous of which was Isaac Ray in 1838 (fifth edition 1871); others include Ryan (1832), Taylor (1845), Wharton and Stille (1855), Ordronaux (1869), Meymott (1882). The typical techniques as outlined in these works are the background for Dr. Neil S. Kaye's widely recognized guidelines that indicate an attempt to feign insanity. One famous example of someone feigning insanity is Mafia boss Vincent Gigante, who pretended for years to be suffering from dementia, and was often seen wandering aimlessly around his neighborhood in his pajamas muttering to himself. Testimony from informants and surveillance showed that Gigante was in full control of his faculties the whole time, and ruled over his Mafia family with an iron fist. Today feigned insanity is considered malingering. In a 2005 court case, ''
United States v. Binion ''United States v. Binion'', 132 F. App'x 89 (8th Cir. 2005), is a case in which the United States Court of Appeals for the Eighth Circuit applied two recent U.S. Supreme Court decisions, '' United States v. Booker'' and '' United States v. Fanfan' ...
'', the
defendant In court proceedings, a defendant is a person or object who is the party either accused of committing a crime in criminal prosecution or against whom some type of civil relief is being sought in a civil case. Terminology varies from one jurisdic ...
was
prosecuted A prosecutor is a legal representative of the prosecution in states with either the common law adversarial system or the civil law inquisitorial system. The prosecution is the legal party responsible for presenting the case in a criminal trial ...
and convicted for obstruction of justice (adding to his original sentence) because he feigned insanity in a Competency to Stand Trial evaluation.


Insult

In modern times, labeling someone as insane often carries little or no medical meaning and is rather used as an insult or as a reaction to behavior perceived to be outside the bounds of accepted norms. For instance, the definition of insanity is sometimes colloquially purported to be "doing the same thing over and over again and expecting a different result." However, this does not match the legal definition of insanity.


See also

* Rosenhan, David L.


References


External links

* * *
"On Being Sane in Insane Places"
{{Authority control Obsolete medical terms Pejorative terms for people with disabilities