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If sanity and insanity exist, how shall we know them?
The question is neither capricious nor itself insane. However much we may be personally convinced that we can tell the normal from the abnormal, the evidence is simply not compelling. It is commonplace, for example, to read about murder trials wherein eminent psychiatrists for the defense are contradicted by equally eminent psychiatrists for the prosecution on the matter of the defendant's sanity. More generally, there are a great deal of conflicting data on the reliability, utility, and meaning of such terms as "sanity", "insanity", "mental illness," and "schizophrenia."
Finally, as early as 1934, Benedict suggested that normality and abnormality are not universal. What is viewed as normal in one culture may be seen as quite aberrant in another. Thus, notions of normality and abnormality may not be quite as accurate as people believe they are.
To raise questions regarding normality and abnormality is in no way to question the fact that some behaviors are deviant or odd. Murder is deviant. So, too, are hallucinations. Nor does raising such questions deny the existence of the personal anguish that is often associated with "mental illness." Anxiety and depression exist. Psychological suffering exists. But normality and abnormality, sanity and insanity, and the diagnoses that flow from them may be less substantive than many believe them to be.
At its heart, the question of whether the sane can be distinguished from the insane is a simple matter: Do the salient characteristics that lead to diagnoses reside in the patients themselves or in the environments and contexts in which observers find them? From Bleuler, through Kretchmer, through the formulators of the recently revised Diagnostic and Statistical Manual of the American Psychiatric Association, the belief has been strong that patients present symptoms, that those symptoms can be categorized, and implicitly, that the sane are distinguishable from the insane. More recently, however, this belief has been questioned. Based in part on theoretical and anthropological considerations, but also on philosophical, legal, and therapeutic ones, the view has grown that psychological categorization of mental illness is useless at best and downright harmful, misleading, and pejorative at worst. Psychiatric diagnoses, in this view, are in the minds of the observers and are not valid summaries of characteristics displayed by the observed.
Gains can be made in deciding which of these is more nearly accurate by getting normal people admitted to psychiatric hospitals and then determining whether they were discovered to be sane and, if so, how. If the sanity of such pseudo patients were always detected, there would be prima facie evidence that a sane individual can be distinguished from the insane context in which he is found. Normality is distinct enough that it can be recognized wherever it occurs, for it is carried within the person. If, on the other hand, the sanity of the pseudo patients were never discovered, serious difficulties would arise for those who support traditional modes of psychiatric diagnosis. Given that the hospital staff was not incompetent, that the pseudo patient had been behaving as sanely as he had been outside of the hospital, and that it had never previously suggested that he belonged in a psychiatric hospital, such an unlikely outcome would support the view that psychiatric diagnosis betrays little about the patient but much about the environment in which an observer finds him.
1.Which of the following is NOT mentioned in the passage?
A、 We can judge precisely what constitutes normality and abnormality.
B、 It is not easy to distinguish sanity from insanity.
C、 It is no doubt that some behaviors of human beings are odd.
D、 Settings where people are living have much to do with how we know what sanity is.
2.What does the word "them" in the last sentence of the fourth paragraph refer to?
A、 Questions from normality and abnormality.
B、 The diagnoses.
C、 Normality and abnormality, sanity and insanity.
D、 People.
3.The word "pejorative" could best be replaced by ( ).
A、 peevish
B、 depreciatory
C、 negative
D、 meaningless
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