The word itself comes from the root adjective "sane," which stems from Latin "sanus," or "healthy." One could reasonably argue, then, that a sane mind is a healthy mind. Let us examine this further. Health, in general, denotes strength, soundness, proper functioning, especially of biological systems. The mind is generally regarded as the seat of awareness and reasoning, leading one to the conclusion that if one's mind is properly functioning, that is, he is clear and accurate in his awareness and reasoning, he might be regarded as "sane."
How shall it be determined, however, what constitutes clear and accurate awareness and reasoning and what constitutes inaccuracy in these areas? To what degree must errancy intrude into the picture before one is determined no longer sane, but InSane??
There are a number of objective criteria whereby one may assess the workings of a mind and determine their accuracy, but the largest portion of these have been declared to be more useful in determining IntelliGence than sanity. One's ability to perform mathematical computations, identify shapes, find the next in a series of deductive steps, identify patterns in data, all are related to mental accuracy, but may be poor indicators of sanity. The kinds of tasks which one performs accurately, then, may have an impact on the perception of one as sane or not.
The most prominent aspect of accurate mental function which has been used as an indicator of sanity over the centuries appears to have been mental function as it relates to two areas: interpersonal relations, and bodily safety of self and others.
More than mere accuracy has been introduced to the picture, however, as conformance and agreement with societal norms have played as great a role in the determination of sanity historically as any other criteria. In some contexts, societal norms loom large. In WesternCivilization?, one would generally find it unsettling if a friend began to speak of voices telling him things, of demons tormenting him, or how he was cured by someone burning incense, shaking rattles, and chanting. Modern psychiatry lists such reported experiences among the symptoms of SchizoPhrenia?. In many regions of the ThirdWorld?, however, shamanistic tradition accepts and reinforces such experience. One who declared to the members of such a culture that these subjective experiences were invalid might find his sanity called into question by the local chief or medicine man.
One can hardly miss the input of culture or of culture(s) if one attempts to determine what the modern western medical community uses as a measure of sanity. In medical circles, the most general definition is by exclusion - that is, "absence of functional mental illness, defect or disorder." This definition will seldom be satisfied in the absolute, as we will see directly.
The "bible" of mental diagnosis is psychiatry's Diagnostic and Statistical Manual (DSM). It has undergone a substantial evolution in the last half-century. From the few mental disorders defined in Freud's time, the number of psychiatric determinations of aberrant human behavior has expanded. When the DSM was first published in 1952, it listed 112 mental illnesses or disorders. The 1994 issue of DSM (IV) specifies more than 370 disorders. And the psychiatric community has not always agreed on how these should be classified. For example, concerning "schizophrenia," DSM-II states, "Even if it had tried, the Committee could not establish agreement about what this disorder is; it could only agree on what to call it." DSM-III says "there is no satisfactory definition that specifies precise boundaries for the concept 'mental disorder'.... For most of the DSM-III disorders... the etiology [cause] is unknown. A variety of theories have been advanced... not always convincing, to explain how these disorders come about." DSM-IV states that the term "mental disorder" continues to appear in the volume "because we have not found an appropriate substitute." Diagnoses which appear in the manual were developed, in part, by a majority vote of those attending DSM conferences. As a result, short attention span, questions about one's spirituality, difficulty with writing or mathematics, defiance of one's parents, fidgeting, excessive neatness, all have found a place in the manual among symptoms and diagnoses. In contrast, homosexuality or the unreasonable desire of a slave to escape, once defined as mental defects (the former in early editions of the DSM), do not appear in today's DSM.
In 1995, Dr. Rex Cowdry, then director of The National Institutes of Mental Health, stated to a U. S. House of Representatives appropriations subcommittee hearing that, regarding mental illness, "We do not know the causes. We don’t have methods of ‘curing’ these illnesses yet." This should not be surprising. It has been without doubt a cultural process, within the fairly limited culture of psychiatry and psychology, which has taken place in an effort to define the boundaries of sanity and insanity. Diseases with cultural definitions may not respond to medical science.
And this may not be altogether in error. If one is raised in a given cultural environment, educated in a given fashion, and exposed to certain norms, then behavior which is inconsistent with these factors may well indicate some defect in the capacity to accurately process the information available to the mind.
In the legal community, a culture unto itself, an entirely different effort has been undertaken to define sanity. Generally speaking, the most broadly known and publicly accepted standard for sanity under law is "the ability to discern right and wrong." This has been broadened, extended, shaped and colored in any number of juristictions in an effort to punish the guilty and forgive those whose temporary or permanent mental state deprived them of the requisite ability to form intent, or "mens rea" (guilty mind) under the law.
Various findings of mental defect by medical professionals have been sent up as trial balloons by defendants, with varying levels of success, in an effort to avoid being found sane, and thus escape a death penalty or any form of punishment at all. Multiple personality disorder, sugar addiction, somnambulance, amnesia, excitement or passion, obsessive-compulsive behavior of varying kinds, all have been pled as defenses before the bar of justice.
Thus far, medical and legal efforts to define sanity have been addressed. The last category your author will look at will be sanity as defined in a political context.
(to be completed as time permits) -- AyeSpy
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