Insanity: The Real Definition

"The definition of insanity is repeating the same mistakes over and over again and expecting different results," utters the know-it-all guy in the coffee shop offering free "therapy" to his visibly shaken friend. He had all the tell-tale signs of the recently heartbroken, and Mr. Fix-It's platitudes didn't seem to be helping. I resisted the urge to butt in with a resounding "no it's not! That's the definition of perseveration!" but felt that my humbly nerdy correction wouldn't contribute much to the bromantic mood of gingerbread lattes and "who needs women" banter. So instead, I'll tell whoever wants to listen, right here, right now. This is not the definition of insanity. It never has been, and it probably never will be.

The above quote has been mis-attributed to Albert Einstein, Benjamin Franklin, and Mark Twain. In fact, none of these great minds were responsible for such a convincing, yet blatantly incorrect definition. The first time it actually appeared in print was in a 1981 Narcotics Anonymous text (page 11).

The term insane is outdated parlance in the mental health community. No legitimate medical or clinical professional would be caught dead saying it in public. It's a legal term. A defendant may be found not guilty by reason of insanity if his or her lawyer can provide clear and convincing evidence that he/she was suffering from severe mental illness (i.e., psychotic disorders like schizophrenia, bipolar disorders, or organic brain illness) which prevented him/her from knowing that the crime committed was, in fact, an illegal act. Because it is a legal distinction, and not a medical one, although forensic psychologists may offer clinical opinions about the mental health of a defendant, only a judge or jury can make determinations about a defendant's insanity.

The quote above is not the only myth about insanity that's commonly seen in popular psychology. Richard Nixon centered his crime fighting efforts against the insanity defense in 1973, attempting to abolish it entirely. A Wisconsin State Journal article quotes a Justice Department lawyer flippantly claiming that, "It does away with the defense of 'I was insane when I committed the crime, but, wonder-of-wonders, I've recovered.'"

Even presidents aren't immune to mythological thinking about popular science and psychology, especially when it adds ammunition to their political arsenals (surprise, surprise). Did Nixon really think that the insanity defense is a convenient loophole that allows for the most brilliantly nefarious thespians to malinger their ways out of prison and into, who knows, Hollywood? Do you think that the insanity defense is a common ploy in the courtroom? If so, do you think that a significant portion of these "criminally counterfeit" walk away scot free after sentencing?

If the idea of an insanity defense sits like a rock in your stomach, and you worry that it is commonly abused, you're not alone. In a 2007 study, undergraduate students were questioned about their attitudes toward the use of the insanity plea in the United States. Students estimated that the defense was used in approximately 30% of cases and was successful approximately 30% of the time. Sound reasonable?

In fact, the insanity defense is used in only 1% of all criminal proceedings, and its success rate is only 25% of that 1%. Therefore, less than 1 in 400 defendants are found not guilty by reason of insanity in this country. Some studies show this rate as being much lower -- closer to 1 in 1000. Public estimates of the number of insanity acquittals are as high as 81 times the actual number. Furthermore, there appears to be no significant difference in length of time served for murder between incarcerated sane criminals and insane persons who were involuntarily committed.

So, why do these misconceptions remain? In the Skeptic Magazine article, "Top Ten Myths of Popular Psychology," the authors write that:

We Americans live increasingly in a "courtroom culture." Between Court TV, CSI, Law and Order, and CNN's Nancy Grace, we're continually inundated with information about the legal system. Nevertheless, this information can be deceptive, because the media devotes considerably more coverage to legal cases in which the insanity defense is successful, like Hinckley's, than to those in which it isn't. As is so often the case, the best antidote to public misperception is accurate knowledge. Lynn and Lauren McCutcheon found that a brief fact-based report on the insanity defense, compared with a news program on crime featuring this defense, produced a significant decrease in undergraduates' misconceptions concerning this defense. These findings give us cause for hope, as they suggest that it may take only a small bit of information to overcome misinformation.

UPDATE: I suppose that the aphorism "there's no such thing as a new idea" is truer than the one I wrote about here! Indeed, Dr. Ryan Howes wrote a post about the very same topic in Psychology Today in 2009. You can read it here.

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Comments

[snowballinhell]

03:28 PM on 12/28/2011

And then to consider the experts can't agree on what is and what isn't mental illness:
http://www.alternet.org/story/153588/are_psychiatrists_inventing_mental_illnesses_to_feed_americans_more_pills/

[DurangoHouston]

06:23 AM on 12/23/2011

Nice explanatory article on insanity as used in the legal system & misunderstanding by the public.
However, you are giving bad rep to the "12-step definition". Very likely none of us are thinking of the legal or the formal medical usage of the term "insanity". I find it very useful in talking with other recovering alcoholics or addicts. I probably most frequently apply it to myself and some recent
idiotic action or thinking. I may only share the expression with non-program people I think will understand the usage.

[nypoet22]

12:13 AM on 12/22/2011

"pop-psychology" may not provide a definitive answer about what constitutes sanity, but the APA and its publications don't necessarily have a monopoly either. cara, before you continue publishing on the topic i suggest you read the works of thomas szasz. i don't believe exactly as he does, but i think his views are a necessary piece of any informed opinion on the mental health professions.

http://en.wikipedia.org/wiki/Thomas_Szasz#Szasz.27s_main_arguments

[Julia Bailey]

12:53 PM on 12/23/2011

As someone who studies psychiatric disorders in families, I think there are some major flaws in Szarsz arguements. He claims diagnoses aren't real, yet they are not only reliable, but they run in families. And this is even when you do diagnoses blind to other family members diagnoses. If they were assigned randomly you wouldn't see familiar patterns.
And we've also found genes the predispose individuals to mental illnesses. That's another really good line of evidence for a biological basis.
BTW, if you have a point to make, you should make it, not just tell someone to read something by someone else. That is incredibly lazy scholarship.

[nypoet22]

03:07 PM on 12/23/2011

with respect, there's not enough space here for a meaningful summary and critique of szasz's work. to get what he's about, you need to read him. have you?

szasz's thesis that mental illness is not really illness may seem absurd considering the wealth of MRI and other objective evidence showing the biochemical differences underlying the behavioral differences. but his observations are extremely important because they point to major flaws in nearly all traditional models of mental health. we label and thereby stigmatize abnormal behavior, without adequately questioning the purpose behind those activities we call "treatment."

[Gunderan]

04:56 PM on 12/21/2011

Wow boy was i wrong i thought it was actually a quote from a scientist Albert Einstien the theoretical physics guy and not a mental health person.
Just goes to show how much ignorance is caused by misusing a simple quote out of context.
Also the state of people involved in the mental health field.
What a rubbish article written with typical 1960's pseudo liberal intellectualism
Flamed and failed

[gmikejake]

07:10 PM on 12/21/2011

What is "typical 1960's pseudo liberal intellectualism?" I must have missed that.

[nypoet22]

02:35 AM on 12/22/2011

don't hold back, tell us what you really think. anyhow, i heard the quote wasn't einstein, it was jesus:

http://www2.cruzio.com/~zerocity/siegman.htm

[nypoet22]

02:45 AM on 12/22/2011

the link seems broken. google "the second coming" by ken siegmann. in the poem, jesus uses the pop-psych line about insanity. plus it's a super poem.

[mrwebber35]

03:25 PM on 12/21/2011

Funny how the Insanity Plea is another way of pleading ignorance. Repeating the same mistake over and over without realizing that you have already tried that exact same attempt without having consciously changing any of the variables is insanity. Perserverance is when one changes a variable or ignorantly changing several of them at the same time when attempting a different positive outcome. Insanity is really just very short term memory loss. Probably from watching too much TV.

[Cara Santa Maria]

03:39 AM on 12/23/2011

What?

[SpreadthePanic]

09:28 AM on 12/21/2011

I was thinking about this quite a bit just a few days ago, so it's great to see this article written.

Much of this repeating of actions over and over and expecting different results stems from the Fundamental Attribution Error. When we see other people making mistakes, we tend to attribute these mistakes to personal characteristics - the person is flawed, unintelligent, lazy, careless, or whatever we feel fits the situation. However, when we make mistakes ourselves, we tend to blame environmental characteristics - my boss doesn't like me, something kept me from getting enough sleep, my coworkers are uncooperative, etc.

When people repeat the same actions and expect different results, in some cases it may be mere perseverance, especially when it is a task that we believe we can improve on. But often, it may just be that we attribute our prior failures on external factors and believe that absent those external factors we may be successful. When we see others doing this, we attribute their failures to personal characteristics and don't understand why they fail to see that the same result is going to happen again and again. However, this isn't due to insanity, it is due to a very universal aspect of human nature.

[dsws]

08:48 AM on 12/21/2011

Certainly the word has a long history of use as a legal term-of-art. But I don't accept the premise that legal usage determines "the real definition". It has an etymology. It has a meaning in ordinary vernacular use. When legal meaning differs from normal meaning, I'm inclined to call it a legal fiction, not a near-universal misuse.

The root is from "sanus," Latin for healthy. So at the core of the concept of insanity is a presumption that it's about mental health, not an arbitrarily designated legal status.

"A defendant may be found not guilty by reason of insanity if his or her lawyer can provide clear and convincing evidence that he/she was suffering from severe mental illness (i.e., psychotic disorders like schizophrenia, bipolar disorders, or organic brain illness) which prevented him/her from knowing that the crime committed was, in fact, an illegal act."

As best I understand it, knowledge of illegality is not the criterion. If the person is unable to control their actions, due to some "mental disease or defect", the insanity defense would traditionally be applicable, but no longer is in the United States. If such a mental condition renders them unable to appreciate the wrongfulness of the act, though, it still is -- even if they thought that it was illegal on a par with getting a parking ticket.

"the insanity defense is used in only 1% of all criminal proceedings,"

How do plea bargains figure into that?

[Cara Santa Maria]

03:39 AM on 12/23/2011

Thank you, dsws. Etymology is fascinating, and I'm glad you made the points you did. In terms of plea bargains, I'm unsure whether a defendant can accept a plea based on insanity. Does anyone posting here know?

[josie klapper]

12:35 AM on 12/28/2011

I believe a second trial was adverted in the Andrea Yates case with a insanity plea bargain after the original guilty verdict was tossed out do to misconduct on the part of a prosecutors witness.

[bllbgwll]

08:27 AM on 12/21/2011

1. An overload of data poured into the sensory apparatus of human brains untrained in critical thinking.
2. An educational system operating on the model of the fast food industry.
3. Fox News, Rush Limbaugh and Glen Beck.
Results: Tea Party, Republican Debate Circus, Congressional gridlock
Biggest Failure: Abysmal national ignorance of mental health and other social issues.

[aacme]

08:13 AM on 12/21/2011

Ok, it's not the definition of insanity. We are not all psychologists. But we all see people (ourselves?) endlessly repeating failed strategies.
If somebody said the definition of perseveration is...etc, instead of thinking about our actions we would say, UUUhh, OK!. Thanks. I'll try to remember that for my next crossword.
Sometimes the best word is not technically correct terminology.

[SpreadthePanic]

09:13 AM on 12/21/2011

I don't want to be correct! I want to remain willfully ignorant!!! I don't care that my use of insanity has nothing to do with insanity!!

[PatTheHat]

07:17 AM on 12/21/2011

Great article, however I have to somewhat disagree.
Perseveration (nice word), okay, I can see where it could be considered that, if any even a minor alterations is made that is, some kind of change however minute in order for any difference to be made.
But it ain't exactly persevering if your just doing the exact same thing over and over, but wanting that forever elusive different result.
Pardon me for the technical term, but that's still nutty...okay, wacko..no, how 'bout somethin' like, 'That ol' boys noodle factory done gone plumb kablooey!'?

[SpreadthePanic]

09:23 AM on 12/21/2011

If the action you are repeating over and over and the result are obvious cause and effect (you keep slamming your hand in the door and expect it not to hurt), then you suffer from a delusion (a fixed, false belief). If every time you have dated someone it has ended in a break up, it is not necessarily insane to date again. If you have applied for several jobs and have been rejected, it is not insane to continue applying for jobs. These would both be examples of persevering.

[Syllogizer]

04:59 PM on 12/22/2011

Didn't either of you look up the definition of the word? 'Perseveration' is NOT the same as "to persevere".

[gmikejake]

07:14 PM on 12/21/2011

Truth is ... sometimes when you persist, it works out. So what is the difference between persistence and perseveration?

[Jeanne Ball]

07:13 AM on 12/21/2011

The definition of anything—'sane,' 'normal,' etc.—is structured in consciousness, and knowledge is different in different states of consciousness. What is 'normal' in ordinary waking state is abnormal in a higher, more expanded state of consciousness. Teaching meditation for 35 years, I see people's states of consciousness transform from ordinary waking (where one is aware only of the surface, changing values) to stages of enlightenment, where awareness opens to the transcendental, non-changing field of Being. When the transcendental field is realized in the midst of daily life, one sees this: life without the experience of transcendental consciousness is abnormal and necessarily riddled with problems—this abnormal state has no stable basis and we're constantly overshadowed by the small, changing values of life. In this state of ignorance, we try again and again to solve problems on the level of the problem, in the same state of mind that created them. It never works, because that state of mind itself is the real problem, that lack of expansive awareness, that lack of access to the full range of creativity, intelligence, and happiness deep inside us. The platitude about doing the same thing over and over, expecting next time a different result, becomes the 'reality' of human life. Regardless of who said it, it's true. To successfully address society's problems we must "regain our full powers of seeing" and fully occupy our own consciousness. Meditation is a way for us to become sane.

[itruth]

07:22 AM on 12/21/2011

Jeanne,there is truth in what you say.I would add that all of western culture lives in a disconnect with the real world.For example, if we take the shoes and clothes from almost any modern western person and thrust them into their own environment outside they might think that our distant ancestors were far more cleaver.I fear that we all should get to know the ground we walk.

[gmikejake]

07:20 PM on 12/21/2011

All well and good. If only our world behaved as you suggest. Problem is ... things like abuse, racism, homophobia, xenophobia, poverty, starvation, serious disability, chronic untreated disease, serious mental health, etc. keep getting in the way of living in such "expansive awareness." Unless, of course, your "awareness" includes fully understanding, and perhaps, even doing what one can do about those conditions. When you are directly experiencing them, they do tend to catch your attention and distract you from "the full range of creativity, intelligence, and happiness deep inside us."

[johnvilvens]

06:04 AM on 12/21/2011

A nice article. The problem is defining normal and abnormal. To say one is sane another is no has to have some standard. In Psychology there is no base line. People are evaluated on social standards. To repeat can be a habit. People keep smoking even if it is harmful to them. They are doing harm to them selves what you call them. You seem to fallen into the same trap of evaluating some one and painting what they say to fit what you want it to mean.

[millebocca]

06:03 AM on 12/21/2011

am a great fan of the 3 greats mentioned, and i cringe to think people would even connect such a banal quip to these men - just goes to show you
"there is nothing more frightful than ignorance in action"
(goethe)
and how we are surrounded by it...at every (sigh) level

[Edward Standley]

05:41 AM on 12/21/2011

Research scientists are wonderfully insane. :)

[jf12]

08:37 AM on 12/21/2011

How so?

[BeetJuice]

05:39 AM on 12/21/2011

Fascinating article. The first time I heard this saying was years ago, and I suspected it wasn't true even then, because of the context in which it was asserted (in the middle of an emotional political debate), and because we all do the same things repeatedly and expect different results. Everyone who plays the lottery may be making a bad choice, but that doesn't mean they're insane. Now I'll have the knowledge to back up my intuitive reaction with the actual facts.