Episode 5: Is there a clear line between madness and sanity?


The Philosofa is back and it’s better than ever! In episode five we explore the question – Is there a clear line between madness and sanity? Joining co-hosts Omar Hamdi and Broderick Chow for a tumble down this philosophical rabbit hole, we have Professor of Philosophy at the University of Birmingham, Lisa Bortolotti; and Professor of Clinical Psychology at the University of Liverpool and author of the award winning, Madness Explained, Richard Bentall.

We’ve all felt down, stressed out, anxious, or had strange thoughts or ideas. Are these ordinary aspects of thought and behaviour fundamentally different from the types of symptoms that are associated with mental illness? If we want to challenge perceptions of mental illness, perhaps we need to explore what the mentally ill and the mentally well actually have in common.

Lisa Bortolotti is currently leading a major research project, called PERFECT, whose aims include studying this issue. A lot of her work is on delusions, which are a symptom of a wide range of psychiatric disorders, including schizophrenia. One of her most important ideas is that delusions have strong similarities with other types of beliefs that are not normally associated with mental illness. In particular, she mentions racist beliefs, or the skewed beliefs people can hold about themselves, their past and behaviour. According to Lisa, this is because both delusions and these other sorts of cognition involve the same sorts of failures of rationality. The difference is often only that delusions tend not to be shared.

Lisa thinks that what makes delusions distinctive is not their irrationality, as is commonly supposed, but the way that they adversely affect a person’s life and wellbeing. Interestingly, she also thinks that delusions can even be beneficial in certain ways and that this may partly be why they are so resistant to challenges.

In his book Madness Explained, Richard Bentall argues more generally that there is no clear boundary between mental illness and ‘normality’. He says that many people have what are seen as standard symptoms of mental illness, including hallucinations, delusions and mood swings or mild mania, but do not experience them as problematic or feel they are need of psychiatric help. Richard also argues that mental illness exists on a complex spectrum. People experience symptoms of mental illness more or less frequently and severely, and vary in the way they experience those symptoms, meaning that whether or not a person has a mental illness is often a matter of degree.

This raises interesting questions – for example, about criminal responsibility. When a serious crime is committed and the mental health of the perpetrator is in question, society often wants a clear verdict: mad or sane? Grey areas just aren’t that convenient.

These are just some of the many issues discussed in this philosophical tour de force. Others include: are shamans just psychiatrists with funny hats; and, what do studies have to tell us about the mental health of comedians.

Feeling inspired? Come and join us for episode 5 of The Philosofa.

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