Advice on Writing Insanity

I didn't want to get into this argument, but I'll bite. (Preface: I'm getting a doctorate in psychology) Within the field of psychology, we use neither "mad" nor "insane" to describe what we call "mental illness." The reason is because they are fundamentally incorrect. Out of these options, "Mental Illness" is the most correct because it is an "illness" in the "mind" which we can treat with psychotherapy and medication.

If you want to be politically and scientifically correct, "Mental Illness" is the correct term. This is stuff we cover in grad school. In law, however, there is a use for the word "Insanity." I'm not clear on what it is, but I think it means "temporary loss of mental faculty due to overwhelming stress or emotion." Something along those lines. However, this is different from the now archaic use of "insanity."

This is now my opinion (switching from facts learned in school): If you want a character to sound more like a layman, or if your story takes place 30 years ago or more, you may choose to use "mad" or "insane."

 

I must disagree. It is not scientifically correct at all to assume that everyone who displays psychotic or similar behaviours has mental illness. In medicine, we don't use term "madness" as diagnosis or description, because we have much more precise terms to describe the various symptoms, but it is very important to recognise that people can (and often do) become psychotic for reasons other than mental illness. Temporal lobe epilepsy, corticosteroid side effects, lupus, infection, post-operative confusion, thyroid dysfunction, alcoholic hallucinosis, brain tumor and a whole host of other physical illnesses can cause symptoms identical to the symptoms of psychosis and mania, which are the two most common presentations where a person loses touch with reality.
So, for example: a person is behaving increasingly bizarrely, hallucinating, deluded, paranoid etc. the people around them notice those behaviours and are concerned. Now, this person happens to have a brain aneurysm causing pressure on parts of the brain which result in these symptoms, but nobody knows this yet because they haven't been diagnosed. Will the people around them be more wrong if they say that they are "developing mental illness" or that they are "going crazy" or "going mad"? Because this person is not developing mental illness at all, they need urgent brain surgery (ie. no medication or psychotherapy will relieve their symptoms).
I agree that "losing touch with reality" is more descriptive, but just like "madness" or "crazy", it has different meanings in common language, because it is a common phrase often used to describe people who are not psychotic but simply misguided (As in: "Look at what she is wearing! After all these years of living in that palace, she's lost all touch with reality").

In situations when a person observing someone who has (medically speaking) lost touch with reality, if the observer happens to be a health professional, they might hazard a guess whether this is a case of mental illness (usually they'd be able to assume something more specific than this) or organic psychosis but others, with no such knowledge, will most likely use the layman terms. Looking through this thread, it is obvious that majority of people have no issues with this terminology.
Personally, I'd never just say that someone is "mad" because I'd be able to tell from their speech, thoughts, facial expression etc what exact problems they have, what their diagnosis may be. For me, to call anyone "crazy" or "mad" is lazy because I can do a lot better than that. But not everyone has a working knowledge of psychology and psychiatry and they should not be forced to use erroneous terminology just because someone kicked up a fuss.

Normally, I don't care what people choose to call what, but to be labelled as someone who is insensitive to the needs of all mentally ill people, as someone who is using derogatory and insulting language designed to hurt anyone who ever suffered with mental illness, just because in a forum discussion about "what makes a character mad (as in "insane" not "angry") I used the word "madness" is ridiculous. Because there is "political corectness" and then there is ignorance resulting in an overkill and impingement on my freedom of speech.

 

An analogy:

If someone wrote, "I want to write about a character who's an invalid, who spends all day in bed, who faints at a moment's notice, who can't lift more than a paperback book. I want it to be clear that they're never going to be strong and active again. But I'm not writing about _illness_," there'd be confusion. If they went on to say, "Do you think that this state of being an invalid would lead to the person fainting when they hear a loud noise?" there would, IMO, be even more confusion.

Sure, it's theoretically possible that a person might be in bed all day, fainting, unable to lift even small objects, for some reason other than illness. For example, maybe someone's draining their blood every night as they sleep. Maybe somebody's drugging them. Maybe somebody's disturbing them all night every night so that they never get any sleep. There could be any number of external influences that are causing them to have symptoms that are not coming from their own system, just as there could be any number of influences that could cause a person to behave erratically, even though the cause for that behavior is not coming from that person's mind.

But is that the most likely explanation? The most likely explanation of someone showing the "invalid's" symptoms would be that they're sick, they have some sort of illness. And for an author to state that they want their character to be an invalid, and they want details about the events around an invalid, such as whether the invalid might faint when they hear a loud noise, but they don't want to talk about _illness_, would, IMO, be rather strange.

And there's nothing wrong with fainting - that is, there are no moral judgments about it. But the original question wasn't about something as harmless about fainting, it was about _violence_. Violence is a very serious thing. It's a thing that gets people locked up, that gets them barred from many aspects of life.

So when we start to talk about nonspecified "madness" and whether this "madness" leads to violence, then I don't think that we're having a completely harmless inoffensive conversation. When we blur the line between "madness" and mental illness and violence, there is substantial cause for offense. Sure, you can still write a book about a person with generic madness. Sure, you can have them be violent. You can do whatever you want. But people can also find that offensive. And now that I've thought this through to a conclusion, I'm one of those offended people.

Edited to add another analogy:

Imagine that you have diabetes. It's well-controlled, and you have no appreciable issues that limit your abilities in your day to day life. You work at a plant nursery; you tend the plants and set up displays, and you love that job. Once in a while you have to take a break for medication, involving access to the bathroom, or you need eat something for blood sugar, but that works fine for you.

You have a coworker, Joe, who has a back problem and can't lift more than fifty pounds. That works fine for Joe; Joe enjoys his job of inspecting the nursery's growing fields that are fifty miles away in a rural area, with no bathroom or other facilities.

Your boss realizes that you and Joe are both "ill". Obviously that means that you _both_ need food and bathroom access and freedom from heavy lifting, because ill is ill, right? Obviously that means that he needs to take you off the job that you love, and put you behind the cash register at the nursery, so that you won't have to lift more than fifty pounds. And he has to take Joe off the job that he loves, and put him behind the cash register as well, so that he has access to the bathroom.

Yeah, yeah, you say, we're not talking about real life, we're talking about a bleeping novel! OK, sure, we're talking about a novel. The main character in the novel has back problems, and therefore he needs reliable access to food so that he can maintain his blood sugar. Does that make any sense? To people who know nothing about back problems, sure, it might; they'll just shrug and assume that's how things are - just as people who know nothing about mental illness may assume that "madness" always makes people prone to violence and _that's_ just how things are.

But wouldn't it be better if the author knew something about the illness that his character has, and what symptoms it involves? Wouldn't that be better in the case of mental illness as well? Is it so _wrong_ to suggest that something more specific than "true madness" be depicted?

ChickenFreak

 

Well, other examples of what could be construed as insanity...

hypoxia - decreased oxygen to the brain and they can not only start talking strange stuff, but they can become violent

hypoglycemia - decreased sugars = decreased energy = inability to think straight, form a complete sentence. Early stages can cause violence. Eventually unconciousness if not treated quickly.

Clogged carotid arteries - decreased blood flow to the brain. Causes Alzheimers type symptoms and is often misdiagnosed as such. These patients can also become violent.

NONE of these patients have mental illness. They have a physiological condition that causes insanity at certain times. It is perfectly acceptable to use such a term in these cases. No one would know if the person is mentally ill or not if they did not know the person in reality. It would take having a history of the patient to know if this is an altered mental status or not.

 

Okay, so where does the physical cause of MI type symptoms come in here?

Yes, people with mental illness will talk among themselves or with professionals as being "mad" or "crazy" - just as blacks will refer to themselves as n******. That doesn't make it okay for people outside the 'group' to use those terms. There are also people with MI who will use those terms among 'laypeople' in an attempt to maintain the illusion of outsider's acceptance of their illness. And maybe the term actually doesn't offend some people. But you know - it would have been so simple to keep this discussion moving in a positive direction - a learning direction as some have indicated they wanted it to go. Simply respect the fact that many many people with mental illnesses do find those terms prejudicial and judgmental, and then not use them. Is it really that difficult to say "mentally ill", or to actually learn about mental illness instead of going by video games?

 

Of course you are right, but that hasn't been the contention in this thread. Initially, everyone suggested various ways in which the idea of "madness" can be best represented, and suggestions were made to look up various mental illness descriptions, because even organic psychoses (ie. not mental illness but organic diseases) will present as psychosis, and only psychiatric texts actually go into detail about various forms of psychosis etc. So it is a logical place to start.
The problem in this post was that one person demanded that all of us stop using term "madness" or "insanity" and replace it with the term "mental illness". This was understandably a controversial demand because not everyone with mental illness has psychosis (ie. "madness/insanity" etc) and not everyone who is psychotic, has mental illness.
This whole thread got completely sidetracked by that.

 

So many people in this thread tried to point this out, to no avail...

 

The Trashcan Man in Steven King's 'The Stand' is a good example of a crazy character in my opinion. To everybody else he's mostly off of his rocker. In his mind though there's a rhyme and reason for what he's doing.

 

I was not attacking you or anybody else on this forum, because to be honest I didn't even read 95% of the posts dealing with this issue. When I wrote the post, I didn't know that you prefer the term "madness." If you want to use madness, that is perfectly in your right via freedom of speech. All I said that - in the field of psychology - we no longer use the words "madness" or "insanity" but instead use "mental illness." I also implied that "mental illness" isn't even the best word for it, and that right now we don't have a perfect word for it because we don't know enough about "Mental illnesses".

In sum, I was not attacking you. I'm not even suggesting that what I'm saying is right. Just putting in my two cents of what I learn in grad school for psych.

 

[Deleted accidental reposting]

 

In a nutshell.

People can find all kinds of things offensive. Still, a writer should be free to use whatever words they choose to in their writing.

 

I am sorry for not making it clear, in the last paragraph I wasn't referring to you at all. Of course you weren't attacking anyone, you were perfectly polite in sharing your point of view. I was referring to another poster. I honestly can't be bothered trying to sum it all up again, but I think, reading the whole thread, it is quite obvious how we got sidetracked.
But really, I am sorry for the misunderstanding

 

I don't believe anyone said offensive language can't be used in one's writing. However, if someone says something that is offensive in a public forum, they should expect to be called on it. Some people apparently can't deal with that aspect of freedom of speech. Deflecting the discussion toward some kind of organic problem when it's obvious that's not what was being originally discussed is one way of sidestepping responsibility for one's words.

 

I understand what you're saying, but I don't see it as the relevant point. You seem to be saying that it's OK to use a generic term "madness" because the behaviors associated with that term might be due to mental illness or (rarely, IMO) other causes. But I don't see how that helps solve the negative results of lumping all mental illness and all behaviors-that-look-like-some-kind-ofmental-illness into one big bucket, without making any distinctions.

I read a lot of old mystery novels. One of those novels included a character who was not mentally ill, but would instead today probably be diagnosed as mentally retarded - he was an adult of child-level intelligence. But at that time, apparently there was no particular distinction made between (1) mental retardation, (2) mental illness, (3) other conditions that could produce behaviors typical of mental illness, and (4) the subset of mental illness that can make a person actually violent and dangerous.

So a plot point in the novel was that the person's relatives were trying to hide this character's mental retardation, because if it were discovered by the authorities, he would quite likely be considered dangerous, and be forcibly institutionalized. As the murder mystery went on, it was made clear that, again, if his mental retardation were known, the authorities would likely _assume_ that he committed the murder. And not only did the characters in the book think that, but the author clearly assumed that the reader of the book would think that as well.

That, IMO, is what happens when people bundle incredibly complex ideas under blanket labels like "true madness". And, no, I'm not saying that the book caused these ignorant attitudes, I'm just using the book as an example of the attitudes that once existed.

I understand that the OP meant no offense. But I really think that he should consider the possibility that he may have something to learn. He didn't like the way that the point was raised, OK, but that doesn't make the point invalid.

Does he really _need_ the term "madness", to the point that it's essential to fight so long and so hard to keep people from objecting to its use? Is it impossible to communicate what he wants by saying, "behaviors characteristic of various forms of mental illness", or something of the sort? Just how valuable _is_ the ability to generalize and simplify dozens or hundreds of conditions under a single simplifying label? How valuable is it to simplify a complex and delicate subject to the point that true understanding is eliminated?

Going back to my example, if the goal were to depict a character who was "ill", would we all be happily chiming in offering random symptoms, or would we be saying, "Um, 'ill' is pretty general; what exactly is wrong with him?" If someone asked if the 'ill' person were likely to be contagious (analogous to asking whether the "mad" person were likely to be violent, in that it makes the person a danger to others) wouldn't we, again, suggest that it would be good to choose an illness? And if the conversation were going down the path of giving the person the symptoms of a diabetic, but also making the person contagious, wouldn't people with diabetes object to that possibly harmful misunderstanding of their disease?

Most of us, including me, know little about mental illness. That fact doesn't make it a simple subject, it just means that it's one that we're ignorant of. When people that are less ignorant of it object to it being simplified in a potentially harmful manner, I find it inappropriate to react with such indignation.

ChickenFreak

 

Ooo, very good analysis muscle979. The first character that came to mind for me was the Joker in Dark Night. He very much had his own "rhyme and reason" within his insanity, but what I particularly liked about him was how the writers integrated his insanity into a device that both worked to explain his being a master villain opposite our hero, Batman, as well as providing a strange charisma that endeared him to the audience. He was a guy you loved to hate.

 

Wow, this is alot of info to take in. Again, to those of you kind enough to continuely provide me with information, thank you all so much. This will help out with the development of the character for sure.

LOL, why does everyone seem to think I'm a guy?

 

It's often a general assumption made on the web, even despite your girly name and avatar.

 

No, all I was saying is that here, on this forum, for the purposes of discussion about this particular character's mental state, the original poster asked about the nature of madness and violence. It was here that it was insisted (quite rudely) that we stop using that term and to substitute it with an incorrect term. I never said that it was adequate to remain on the level of this generic idea, if one is to write a book. I don't think anyone who posted in this thread said anything of the kind.
Frankly, I was astonished by the antagonism coming from this one person, and nothing that I or anyone else said managed to get the discussion back on track. At this point, I hope you understand, I am totally sick and tired of repeating what I said already. I'll just assume that you read all my comments.
Also, just as a general point, physical causes of psychosis and mania are by no means rare, and it is much more common than you think. I know this from professional experience.

The example you quoted is a good one and I totally agree with you. But I never stated that character development should stop at that stage, even though the person objecting to the word "madness" kept bringing the discussion back to that point again and again. I have no idea why.

I think OP is well aware that they have something to learn. Like the way to craft a character that would be, generally speaking, considered to be "insane". I think it is precisely because of this, that she used the geneic word, because there are so many possibilities to choose from.

Look, I don't know how others feel, but I do not react well to bullying. I feel that this insisting, deliberate misquoting, emotional blackmail-type arguments, sarcasm etc. (and I am only talking about one particular set of comments, nobody else) is essentially bullying.
Because I know that what I am saying is right. I have worked as a professional in this field for too long to be told what words I am allowed and not allowed to use. It might be my personality, but it is also my practical knowledge, that prevents me from giving in to unreasonable demands.

But don't you see that this was the exact advice I and most posters in this thread gave to the OP?

Overall, I would completely agree with you, but what you think happened is not quite what happened. All I can say is that this is a perfect example of how 4 pages down the line, Chinese whispers and all, what we end up talking about has little to do with what we talked about in the beginning.

 

If i were to write something with a mad person in it, they would have mood swings, split personalitys and a lot of the time be disconnected from reality, escaping to there own world deep inside there mind........
And if they mad-evil, they'd have weird dillusional thoguhts about killing people or rape

 

12 Monkeys. Another great movie to have a look at. It's actually my favourite movie, no idea why it only came to me now. There's this part in the film I love that I'll add here:

The Jeffrey character is really interesting, you should definitely give it a watch.

 

Tell me about it, I use cari as my username on most places that require a username and everyone always writes "carl" and I'm like... Cari... i... Cariiiiii....

 

I see little difference. Forum posts are often hypothetical and abstract discussions at that (and often for research), and not personal attacks towards anyone.

People have the right to be offended and point that out, by all means. How someone responds to that is up to the individual, still.

 

I'm so glad someone finally got around to posting this. I don't even know why this thread is still going on. >.< I was tempted to paraphrase most of this video to a response from a couple pages back, but yeah... thanks. +Rep for that.

"He made a joke about the church, and when I woke up the next morning, I had LEPROSY!" xD

 

What's wrong with using the word 'colored'? Who cares if blacks are offended by it - they should grow up, right?

And just to point out - working with the mentally ill is very very different from being mentally ill and having to deal with those who think of us as 'insane'. But of course, we're nuts so who needs to listen to our concerns?