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Insanity

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Engraving of the eighth print ofA Rake's Progress,depicting inmates atBedlam Asylum,byWilliam Hogarth

Insanity,madness,lunacy,andcrazinessarebehaviorscaused by certainabnormalmental or behavioral patterns. Insanity can manifest as violations ofsocietal 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 ofcontagion(thatmental illnessis infectious) as in the case ofcopycat suicides.In contemporary usage, the terminsanityis an informal, un-scientific term denoting "mental instability"; thus, the terminsanity defenseis the legal definition of mental instability. In medicine, the general termpsychosisis used to include the presence ofdelusionsand/orhallucinationsin a patient;[1]and psychiatric illness is "psychopathology",notmental insanity.[2]

In English, the word "sane" derives from the Latin adjectivesanus,meaning "healthy".Juvenal's phrasemens sana in corpore sanois 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 iscompos mentis( "sound of mind" ), and a euphemistic term for insanity isnon compos mentis.In law,mens reameans 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.[3]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.[4]More recent research on the historical practice oftrepanningsupports the hypothesis that this procedure was medical in nature and intended as means of treating cranial trauma.[5]

Ancient Greece

TheGreeksappeared 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 inbodily humors.Hippocratesfrequently wrote that an excess of black bile resulted in irrational thinking and behavior.[6]

Goya'sMadhouse,1812-1819

Ancient Rome

Romansmade 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 ofpsychosomaticillness. 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,[7]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 ".[8]

From the Middle Ages onward

TheMiddle Ageswitnessed the end of the progressive ideas of the Greeks and Romans.[clarification needed]

During the 18th century, the French and the British introduced humane treatment of the clinically insane,[9]though the criteria for diagnosis and placement in an asylum were considerably looser than today, often including such conditions asspeech disorder,speech impediments,epilepsy,anddepressionor being pregnant out of wedlock.

Europe's oldestasylumwas the precursor of today'sBethlem Royal HospitalinLondon,known then asBedlam,which began admitting the mentally ill in 1403 and is mentioned inChaucer'sCanterbury Tales.The firstAmericanasylum was built inWilliamsburg, Virginia,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 instraitjackets.

Medicine

Insanity is no longer considered a medical diagnosis but is a legal term in the United States, stemming from its original use incommon law.[10]The disorders formerly encompassed by the term covered a wide range ofmental disordersnow diagnosed asbipolar disorder,organic brain syndromes,schizophrenia,and otherpsychoticdisorders.[1]

Law

In United Statescriminal law,insanity may serve as an affirmative defense to criminal acts and thus does not need to negate anelementof the prosecution's case such as general or specific intent.[11]Each U.S. state differs somewhat in its definition of insanity but most follow the guidelines of theModel 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 aspsychosisbut will not accept the diagnosis of apersonality disorderfor 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 alegal questionand not a medical one, the judge and or jury will make the final decision regarding the defendant's status regarding aninsanity defense.[12][13]

In most jurisdictions within the United States, if the insanity plea is accepted, the defendant is committed to apsychiatric institutionfor 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 cantollthe statute of limitations for filing a suit until gaining sanity, or until astatute of reposehas 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 wasIsaac Rayin 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.[14]

One famous example of someone feigning insanity isMafiaBossVincent 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.[15]

Today feigned insanity is consideredmalingering.In a 2005 court case,United States v. Binion,thedefendantwasprosecutedandconvictedforobstruction of justice(adding to his originalsentence) because he feigned insanity in aCompetency 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."[16]However, this does not match the legal definition of insanity.[17]

See also

References

  1. ^abL M Tierney, S J McPhee, M A Papadakis (2002).Current medical Diagnosis & Treatment. International edition.New York: Lange Medical Books/McGraw-Hill.pp. 1078–1086.ISBN0-07-137688-7.
  2. ^An interview with Dr. Joseph Merlino,David Shankbone,Wikinews,5 October 2007.
  3. ^Weinstein, Raymond M. (2007) "madness" in George Ritzer (ed.)The Blackwell Encyclopedia of Sociology,Blackwell Publishing,2007, pp. 2693-2695
  4. ^Porter, Roy (2002)Madness: A Brief History,Oxford University Press,2002, p.10,ISBN0-19-280266-6
  5. ^Andrushko, Valerie A.; Verano, John W. (1 September 2008). "Prehistoric trepanation in the Cuzco region of Peru: A view into an ancient Andean practice".American Journal of Physical Anthropology.137(1): 11–12.doi:10.1002/ajpa.20836.PMID18386793.
  6. ^Weinstein 2007, p. 2693
  7. ^Craighead, W. Edward (2002).The Corsini Encyclopedia of Psychology and Behavioral Science.John Wiley and Sons.p. 941.ISBN0-471-27082-2.
  8. ^Robinson, Daniel N. (1995).An intellectual history of psychology.University of Wisconsin Press.p.305.ISBN0-299-14844-0.
  9. ^Scull, Andrew (1981).Madhouses, Mad-doctors, and Madmen: The Social History of Psychiatry in the Victorian Era.Philadelphia:University of Pennsylvania Press.pp.105–116.ISBN0-8122-7801-1.
  10. ^Tighe, Janet A. (2005).""What's in a Name?": A Brief Foray into the History of Insanity in England and the United States ".Journal of the American Academy of Psychiatry and the Law.33(2): 252–8.PMID15985670.Archived fromthe originalon 2011-09-28.Retrieved2007-10-20.
  11. ^Poortinga, Ernest; G (2007)."Criminal Responsibility and Intent".Journal of the American Academy of Psychiatry and the Law Online.35(1). jaapl.org: 124. Archived fromthe originalon 2011-09-28.Retrieved2008-02-22.
  12. ^Shapiro, David L. (1991).Forensic Psychological Assessment: An Integrative Approach.Needham Heights, MA:Simon & Schuster.pp. 70–72.ISBN0-205-12521-2.
  13. ^Gary, Melton (1997).Psychological Evaluations for the Courts: A Handbook for Mental Health Professionals and Lawyers(2nd ed.). New York:The Guilford Press.pp.186–248.ISBN1-57230-236-4.
  14. ^Neil S. Kaye M.D."Feigned Insanity in Nineteenth Century America Legal Cases"(PDF).
  15. ^Selwyn, Rabb (19 December 2005)."Vincent Gigante, Mafia Leader Who Feigned Insanity, Dies at 77".New York Times.Retrieved24 April2011.
  16. ^"Insanity is Doing the Same Thing over and over Again and Expecting Different Results – Quote Investigator".23 March 2017.
  17. ^"The Definition of Insanity – Psychology Today".