View source for Insanity

{{Short description|Abnormal mental or behavioral patterns}}
{{Other uses|Insanity (disambiguation)}}
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{{redirect-multi|2|Insane|Crazy}}
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[[File:The Rake's Progress 8.jpg|thumb|300px|Engraving of the eighth print of ''[[A Rake's Progress]]'', depicting inmates at [[Bethlem Royal Hospital|Bedlam Asylum]], by [[William Hogarth]]]]
'''Insanity''', '''madness''', '''lunacy''', and '''craziness''' are [[behavior]]s caused by certain [[Abnormality (behavior)|abnormal]] mental or behavioral patterns. Insanity can manifest as violations of [[Norm (sociology)|societal norms]], 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 [[Infection|contagion]] (that [[mental illness]] is infectious) as in the case of [[copycat suicide]]s. In contemporary usage, the term ''insanity'' is an informal, un-scientific term denoting "mental instability"; thus, the term [[insanity defense]] is the legal definition of mental instability. In medicine, the general term [[psychosis]] is used to include the presence of [[delusion]]s and/or [[hallucination]]s in a patient;<ref name="diag">{{cite book| last = L M Tierney, S J McPhee| first = M A Papadakis| title = Current medical Diagnosis & Treatment. International edition| publisher = Lange Medical Books/[[McGraw-Hill]]| year = 2002| pages = 1078–1086| location = New York| isbn = 0-07-137688-7}}</ref> and psychiatric illness is "[[psychopathology]]", not ''mental insanity''.<ref name=DS>[[n:Dr. Joseph Merlino on Sexuality, Insanity, Freud, Fetishes and Apathy|An interview with Dr. Joseph Merlino]], David Shankbone, ''[[Wikinews]]'', 5 October 2007.</ref>

In English, the word "sane" derives from the Latin adjective ''sanus'', meaning "healthy". [[Juvenal]]'s phrase ''[[mens sana in corpore sano]]'' 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]]'' ("sound of mind"), and a euphemistic term for insanity is ''non compos mentis''. In law, ''[[mens rea]]'' means having had criminal intent, or a guilty mind, when the act (''[[actus reus]]'') 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.<ref>Weinstein, Raymond M. (2007) "madness" in George Ritzer (ed.) ''The Blackwell Encyclopedia of Sociology'',  [[Blackwell Publishing]], 2007, pp. 2693-2695</ref> 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 that the holes would allow to escape.<ref>Porter, Roy (2002) ''Madness: A Brief History'', [[Oxford University Press]], 2002, p.10, {{ISBN|0-19-280266-6}}</ref> More recent research on the historical practice of [[trepanning]] supports the hypothesis that this procedure was medical in nature and intended as means of treating cranial trauma.<ref>{{cite journal|last=Andrushko|first=Valerie A.|author2=Verano, John W.|title=Prehistoric trepanation in the Cuzco region of Peru: A view into an ancient Andean practice|journal=American Journal of Physical Anthropology|date=1 September 2008|volume=137|issue=1|pages=11–12|doi=10.1002/ajpa.20836|pmid=18386793}}</ref>

===Ancient Greece===
The [[Ancient Greece|Greeks]] 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 [[Humorism|bodily humors]]. [[Hippocrates]] frequently wrote that an excess of black bile resulted in irrational thinking and behavior.<ref>Weinstein 2007, p. 2693</ref>
[[File:Casa de locos.jpg|thumb|240px|[[Francisco Goya|Goya]]'s ''[[The Madhouse|Madhouse]]'', 1812-1819]]

===Ancient Rome===
[[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]] illness. The Romans also supported humane treatment of the mentally ill, and in so doing, codified into law the principle of insanity as a mitigation of responsibility for criminal acts,<ref>{{Cite book
  | last =Craighead
  | first = W. Edward
  | title = The Corsini Encyclopedia of Psychology and Behavioral Science
  | publisher = [[John Wiley and Sons]]
  | year = 2002
  | page = 941
  | isbn = 0-471-27082-2}}</ref> although the criterion for insanity was sharply set as the defendant had to be found "''non compos mentis''", a term meaning "not sound of mind".<ref>{{Cite book
  | last = Robinson
  | first = Daniel N.
  | title = An intellectual history of psychology
  | publisher = [[University of Wisconsin Press]]
  | year = 1995
  | page = [https://archive.org/details/intellectualhist00robeho/page/305 305]
  | url = https://archive.org/details/intellectualhist00robeho/page/305
  | isbn = 0-299-14844-0
  }}</ref>

===From the Middle Ages onward===
The [[Middle Ages]] typically continued a number of ideas of the Greeks and Romans, such as humoral theory, building on [[Galenic medicine|Galenic]] medicine, which remained foundational into the Modern Era. The [[Late Middle Ages|Late Medieval]] and [[Early modern period|Early Modern period]] saw the rise of mentally impaired people employed as [[Jester|court jesters]], which provided them a certain legal privilege. As in the classical world, certain bouts of madness could be associated with spiritual possession, and people who displayed psychoses could be seen in several ways depending on context, evoking anything from pity to revulsion, such as in the complex case of [[Charles VI of France]], who variously suffered from memory loss, confusion, and [[glass delusion]].{{clarify|date=April 2011}}

During the 18th century, the French and the British emphasised a need for humane treatment of the clinically insane,<ref>{{cite book|last=Scull|first=Andrew|title=Madhouses, Mad-doctors, and Madmen: The Social History of Psychiatry in the Victorian Era|year=1981|publisher=[[University of Pennsylvania Press]]|location=Philadelphia|isbn=0-8122-7801-1|pages=[https://archive.org/details/madhousesmaddoct0000unse/page/105 105]–116|url-access=registration|url=https://archive.org/details/madhousesmaddoct0000unse}}</ref> though the criteria for diagnosis and placement in an asylum were considerably looser than today, often including such conditions as [[speech disorder]], speech impediments, [[epilepsy]], and [[Major depressive disorder|depression]] or being pregnant out of wedlock.

Europe's oldest [[Psychiatric hospital|asylum]] was the precursor of today's [[Bethlem Royal Hospital]] in [[London]], known then as ''Bedlam'', which began admitting the mentally ill in 1403 and is mentioned in [[Geoffrey Chaucer|Chaucer]]'s ''[[Canterbury Tales]]''. The first [[United States|American]] asylum was built in [[Williamsburg, Virginia]], circa 1773. Before advancements in therapeutic treatment during the 19th and 20th century, these hospitals were moreso used to isolate the ostracised mentally ill from society rather than cure them or maintain their health. Pictures from this era frequently portray patients bound with rope or chains, often to beds or walls, or restrained in [[straitjacket]]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]].<ref>{{cite journal
|year=2005
|pages=252–8
|author=Tighe, Janet A.
|issue=2
|url=http://www.jaapl.org/cgi/content/full/33/2/252?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&searchid=1&FIRSTINDEX=40&minscore=5000&resourcetype=HWCIT
|volume=33
|title="What's in a Name?": A Brief Foray into the History of Insanity in England and the United States
|journal=[[Journal of the American Academy of Psychiatry and the Law]]
|access-date=2007-10-20
|pmid=15985670
|archive-date=2011-09-28
|archive-url=https://web.archive.org/web/20110928175136/http://www.jaapl.org/cgi/content/full/33/2/252?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&searchid=1&FIRSTINDEX=40&minscore=5000&resourcetype=HWCIT
|url-status=dead
}}</ref> The disorders formerly encompassed by the term covered a wide range of [[mental disorder]]s now diagnosed as [[bipolar disorder]], [[organic brain syndrome]]s, [[schizophrenia]], and other [[Psychosis|psychotic]] disorders.<ref name="diag"/>

==Law==
{{Main|Insanity defense}}
In United States [[criminal law]], insanity may serve as an affirmative defense to criminal acts and thus does not need to negate an [[Element (criminal law)|element]] of the prosecution's case such as general or specific intent.<ref>{{cite journal
|url=http://www.jaapl.org/cgi/content/full/35/1/124?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&searchid=1&FIRSTINDEX=0&minscore=5000&resourcetype=HWCITCriminal
|title=Criminal Responsibility and Intent
|author=Poortinga, Ernest
|publisher=www.jaapl.org
|pages=124
|issue=1
|volume=35
|journal=Journal of the American Academy of Psychiatry and the Law Online
|author2=G
|access-date=2008-02-22
|year=2007
|archive-date=2011-09-28
|archive-url=https://web.archive.org/web/20110928175001/http://www.jaapl.org/cgi/content/full/35/1/124?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&searchid=1&FIRSTINDEX=0&minscore=5000&resourcetype=HWCITCriminal
|url-status=dead
}}</ref> 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]] but will not accept the diagnosis of a [[personality disorder]] 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 [[ultimate issue (law)|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]].<ref name="shapirointer">{{cite book
| first=David L.
| last= Shapiro
| year= 1991
| title= Forensic Psychological Assessment: An Integrative Approach
| publisher=[[Simon & Schuster]]
| location=Needham Heights, MA
| pages=70&ndash;72
| isbn=  0-205-12521-2}}</ref><ref name="melton1997">{{cite book
| first=Melton
| last=Gary
| year=1997
| title=Psychological Evaluations for the Courts: A Handbook for Mental Health Professionals and Lawyers
| edition=2nd
| publisher=[[The Guilford Press]]
| location=New York
| pages=[https://archive.org/details/psychologicaleva0000unse/page/186 186&ndash;248]
| isbn=1-57230-236-4
| url=https://archive.org/details/psychologicaleva0000unse/page/186
}}</ref>

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 [[Tolling (law)|toll]] the statute of limitations for filing a suit until gaining sanity, or until a [[statute of repose]] 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), [[John Ordronaux (doctor)|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.<ref>{{cite web |url=http://courtpsychiatrist.com/pdf/Feigned%20Insanity%20in%20Nineteenth.pdf|title=Feigned Insanity in Nineteenth Century America Legal Cases |author=Neil S. Kaye M.D.}}</ref>

One famous example of someone feigning insanity is [[American Mafia|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.<ref>{{cite news|last=Selwyn|first=Rabb|title=Vincent Gigante, Mafia Leader Who Feigned Insanity, Dies at 77|url=https://www.nytimes.com/2005/12/19/obituaries/19cnd-gigante.html?pagewanted=1&_r=1|newspaper=[[New York Times]]|access-date=24 April 2011|date=19 December 2005}}</ref>

Today feigned insanity is considered [[malingering]]. In a 2005 court case, ''[[United States v. Binion]]'', the [[defendant]] was [[prosecuted]] and  [[conviction|convicted]] for  [[obstruction of justice]] (adding to his original  [[Sentence (law)|sentence]]) because he feigned insanity in a [[Competency evaluation (law)|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."<ref>{{Cite web|url=https://quoteinvestigator.com/2017/03/23/same/|title = Insanity is Doing the Same Thing over and over Again and Expecting Different Results – Quote Investigator| date=23 March 2017 }}</ref> However, this does not match the legal definition of insanity.<ref>{{Cite web|url=https://www.psychologytoday.com/us/blog/in-therapy/200907/the-definition-insanity|title = The Definition of Insanity – Psychology Today}}</ref>

==See also==
* [[David Rosenhan|Rosenhan, David L.]]

==References==
{{Reflist|2}}

==External links==
*{{commons category-inline}}
*{{Wiktionary-inline}}
*{{Wikiquote-inline}}
*[http://psychrights.org/Articles/Rosenham.htm "On Being Sane in Insane Places"]

{{Authority control}}

[[Category:Insanity| ]]
[[Category:Obsolete medical terms]]
[[Category:Pejorative terms for people with disabilities]]