Frem asks:

What do you call ‘mental sanity’? Would anyone dare to answer?

Answer by Craig Skinner

Here’s an answer, although I dont feel daring.

“Sanity” means “health” (Latin sanus=healthy) so that “mental sanity” means “mental health”. However,the term is rarely used when speaking of physical health, so that “sanity”/”insanity” refer to mental health/disease (and some physical diseases eg syphilis, can also produce mental disease).

The notion of “insanity” is narrower than “mentally ill” Most mentally ill people are not insane. “Insanity” implies that the disease is bad enough to cause loss of reason, inability to tell right from wrong, and is a term used by lawyers rather than doctors these days, as “not guilty by reason of insanity” is a common defence to a murder charge. Among doctors and nurses, the terms “delirium” and “psychosis” are respectively used for fleeting and persistent loss of reason. Delirium can be due to feverish illness, drugs or alcohol, and psychosis is usually due to schizophrenia or severe bipolar disorder.

In short, sanity implies mental health, or mental illness insufficient to cause loss of reason. The term is often used loosely to express praise in other contexts (eg sane policies).

There is a tendency for lawyers to extend the insanity defence beyond the conditions I have mentioned, to include, for example, genetic variants known to be associated with aggression, or people with damage to the amygdala causing lack of emotional response to another’s suffering, the “my brain made me do it” defence. One difficulty for the defendant here is that if the defence be accepted, and nothing can be done to change the brain, he is liable to be locked up for at least as long as if he plead guilty.

I wonder if your mention of anyone “daring” to answer, reflects the view that there is no real sanity/insanity distinction, just labelling by the regime in power of their views and those expressed by opponents. It is true that some regimes have labelled troublesome “dissidents” insane and locked them up, and this still goes on. But this is abuse of psychiatry, and shameful activity by doctors involved. It doesnt mean that mental illness is an arbitrary social construct. Tell that to my sister with schizophrenia or my cousin with bipolar disorder whose lives were ruined by their illness, although greatly helped by medication and ECT.