One of the questions I regularly ask myself, as a psychotherapist, is “What is sanity?” In other words, how do we/I define mental health so we can know if things are improving? This is a very important question because it informs the very foundation of the practice of counseling. For me, this question often spurs a torrent of other related inquires. Let’s take a little journey now down the rabbit hole and into the not so solid meaning of sanity.
Questioning Conforming to the Norm
When pondering the definition of mental health I often wonder if it is only defined by the average or by what is ‘normal’, or can it exist outside of time and culture? Historically, when mental health is completely tied to the consensus reality of our time and place, those that fall outside the norm are labeled mentally disturbed or ill, though they may simply be experiencing other aspects of reality. If mental health is only based on normalcy this exclusion also occurs within the individual and shows up when we deny parts of ourselves that don’t fit into the consensus reality box.
We all believe things about ourselves and the world that are untrue/unreal, does this mean we all carry a little bit of insanity with us? If our perception of reality is filtered through our own mix of sanity or insanity, who are we to even define what it is? This phenomenon, which we could call the researcher bias is particularly troubling to me and a conundrum I don’t know if we are fully capable of overcoming. At worst this bias creates stifling definitions of mental health that devalue and condom wise individuals and wise parts within us all. At best we can take this understanding of unavoidable researcher bias and say that it’s presence necessitates an ever expanding and updated definition of sanity. Let’s take a look at what the standard definitions of sanity currently point toward.
A Logical Definition
Google defines sanity as, “the ability to think and behave in a normal and rational manner; sound mental health.” Merriam Webster defines it as “The condition of having a healthy mind: the condition of being based on reason or good judgment.” Both of these definitions clearly place the rational logical mind at the center of sanity and sanity at the center of mental health. However, there are plenty of highly rational and logical people in the world who are not happy and could not be said to be particularly mentally healthy or experience high levels of life satisfaction.
In my opinion the above definitions are far too narrow and are not particularly useful to me as a mental health practitioner. What would our world be like without the incredible life giving power of music and poetry, two arguably illogical mediums. The assumption that sanity resides solely within logic and rationality leaves out a big part of the human experience, namely spiritual experience, creativity, body wisdom, and emotion. In fact, our emotional being contains a great deal of intelligence and wisdom, and if we deny it through heavy-handed logic we often suffer.
To only use logic and functionality as a measure of mental health would be irresponsible counseling. Grief is a great example of an experience that, if the symptoms were considered without context, could be labeled as a mental illness. Of course we all know that grief is a natural process in response to loss, and if supported and allowed to flow, can result in great healing and transformation. In the instance of grief, releasing the logical minds hold on our being and trusting the grieving process actually often leads to more mental health. This line of thinking can and has been applied to other experiences that often get labeled as forms of insanity. The pioneering psychiatrist Stanislav Grof, coined the term Spiritual Emergency to both normalize and distinguish the experience of those going through dramatic but healthy shifts in perception of reality, from mental illness. Through the study of many indigenous cultures and psychedelic assisted psychotherapy, Grof came to the conclusion that, if done skillfully,
Stepping outside of consensus reality is in fact a crucial ingredient of mental health and human growth and development.
From Definitions to Development
At this point you might be wondering how all this informs how I work as a counselor and how that impacts the experience of any given client. Firstly, I think it is a good thing for any counselor to keep the question “What is Sanity?” open with a working definition of mental health that can shift and adapt. There are also few general signs that I look for as a psychotherapist that tell me that my client is making progress toward greater levels of mental health. These signs have more to do with how someone relates to themselves and the world then the achievement of specific goals that we might set forth, though goals can be helpful. These signs, which are admittedly a product of our time and culture, include:
- An increased sense of choice and freedom
- An increase in presence (living in the present moment) and one’s ability to connect with self and other
- An increase in self-compassion
- More consciously flexible boundaries; a solid “No” and a solid “Yes”
- An increase in psychological resiliency
- An increase in one’s ability to intentionally move in and out of varying states of consciousness with ease
I do not assert that these six qualities define sanity in any sort of solid way, though they do inform my working definition of mental health, as their increased presence seems to lead to more prolonged periods of joy, peace, and love, as well as functionality. If I were to attempt a definition of sanity and mental health it would certainly include these states of being and abilities.
Going Deeper With The Signs of Sanity
An increased sense of choice and freedom:
This means that behaviors that used to be unconscious reactions are now starting to become conscious choices. For example, if your habitual response to someone cutting you off on the road is to honk and curse at them, an increased sense of choice might include the ability to notice the impulse before you act and then choose to consider other possibilities. To the degree that we feel we have choice about how we respond to the world we feel equal degrees of freedom, and freedom feels good! Our sense of choice and freedom increases when we allow for the unconscious to be brought up into the light and become conscious.
An increase in presence and one’s ability to connect with self and other:
Connection happens on many levels. More than anything however, connection is a felt sense, and it all begins with being present. I can feel different levels of contact with a client at any given time, in other words how present they and I are in the room and how available they are for making contact. Most people feel varying degrees of connection in their lives. However, feeling isolated, alone, and out of connection is a recipe for depression, anxiety, and a range of mental health struggles.
There are so many ways we defend against and block connection, usually out of fear. Identifying and transforming these obstacles to connection are a huge part of what happens in counseling.
An increase in self-compassion:
The cultivation of self-compassion may not be an essential component of mental health throughout all cultures, however here in the West it is a major stumbling block. Though a far bigger discussion than the scope of this post, one’s inherent worth and goodness is a big question for many people in our culture and tends to be tied to our behavior and achievements. See my blog series Born Broken for an in depth exploration of this topic. Uncoupling our inherent worthiness of love and goodness from our actions and learning to cultivate loving-kindness towards ourselves is a big part of the therapeutic journey.
More conscious and flexible boundaries; a solid “No” and a solid “Yes”:
A boundary can be expressed in words, physical actions, and even energetically. Boundaries are what keep us safe from harm. When boundaries are functioning properly they prevent us from staying in a harmful situation, such as an abusive relationship, and also allow us to connect with others when we want to. The two key ingredients to healthy boundaries are awareness and flexibility. If we are aware of our boundaries and adept at expressing them, we can shift their permeability to fit the moment we are in. We can also take action before they get crossed, which allows us to effectively navigate relationship without the need to lash out and without getting repeatedly hurt. When we have healthy flexible boundaries we are able to say “Yes” or “No” to others and truly mean what we say. This has a huge positive impact on our relationships and our sense of wellbeing.
An increase in psychological resiliency:
Essentially, resiliency is our ability to bounce back from difficult or challenging experiences. For example, if you get fired from your job, you might feel feelings such as anger and sadness, and then in a few days or weeks start to look for a new job. Another individual might spiral into a deep depression for weeks or even months before they start feeling OK about themselves and looking for a job again. Anyone who uses resiliency as a marker of mental health also needs to be careful not to zoom in too close. Growth is not always linear and sometimes a life event knocks us of our seat in a big way and can be a huge opportunity for growth and healing. However, over the long term development of an individual, resiliency does seem to be a positive sign of mental health.
An increase in one’s ability to intentionally move in and out of varying states of consciousness with ease:
By “varying states of consciousness” I mean such things as awareness of the emotional body, the physical body, and spirit (for those who relate to a higher power). It is also important for one to be able to return to a grounded functional state when needed. This is why I use the word “intentional.” Here, instead of drowning in altered states of consciousness or avoiding them all together, one is essentially learning how to swim in them. This ability to travel between states, such as intense grief, anger, or oneness, does not mean we leave the logical mind completely behind, but rather we can loosen its grip a little in order to explore. Some need the opposite kind of support and find themselves constantly adrift in an ocean of feelings and experiences with no land in sight and no way to integrate. Here again an increased ability to intentionally navigate these waters and return to a grounded functional state of consciousness is at the heart of this sign of growth.
Toward a New Meaning of Mental Health
Perhaps it is time for a new definition of sanity and thus mental health. Perhaps we in the West are still reacting to the darkness of the middle ages with its religious persecution, superstition, and disease, and the salvation that science and rational thought brought during the enlightenment. We may have needed to swing far into the left-brain rational mind to counteract the ignorance of the time, however it may also be time to loosen our grip a little and reexamine our definition of sanity. There are many ways of knowing, and if we are to include wisdom, which someone once wisely called “knowledge filtered through the heart,” within the definition of sanity, we must include all aspects of what it means to be human. We must also include an understanding that reality is incomprehensibly greater and far more diverse than the socially constructed box of normalcy that we often adhere to. As we learn and evolve as conscious beings both the truth and sanity are fluid and ever expanding. I see it as our job as a society, and especially those in mental health, to continually explore and update a working definition of sanity. In this way we leave the limits of human evolution open with no ceiling to the heights of true mental health.
I leave you with my working definition of sanity:
Sanity exists on an ever expanding continuum as a grounded, connected, present and fluid state of being that promotes greater and greater states of love, peace, and joy.