How to Talk to Crazy People II: The Continuum from Normal to Crazy

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This post is one in a series about how we separate ourselves from crazy people (an admittedly provocative label) because they frighten us, and because we wish to make clear that we are not like them. This is both inaccurate psychologically, and hurts the people we are claiming to help, as a recent mission statement by the British Psychological Association has made clear (see Part I). And our biological, genetic, and neurochemical explanations for mental disorders stand for—and exacerbate—this cultural predilection.

In the meantime, confirmation for this has come from an unusual place: The Proceedings of the National Academy of Sciences, in an article entitled, “Effects of Biological Explanations for Mental Disorders on Clinicians’ Empathy”:

To the contrary, biological explanations evoked significantly less empathy. These results are consistent with other research and theory that has suggested that biological accounts of psychopathology can exacerbate perceptions of patients as abnormal, distinct from the rest of the population, meriting social exclusion, and even less than fully human. … This is alarming because clinicians’ empathy is important for the therapeutic alliance between mental health providers and patients and significantly predicts positive clinical outcomes.

Crazy People in Everyday Life

When I used to go to the bagel shop in my small New Jersey town, I regularly encountered a talkative, boastful guy. His stories were preposterous, but amusing, if you didn’t worry about why he felt a need to inflate his claims about himself so outrageously.

Then, one day, I came into the Bagel Buffet and the same man was babbling nonsensically. He was obviously in the midst of a psychotic episode. Yet, if I listened carefully, the stories he blurted out compulsively actually resembled the exaggerated, but not insane, stories he formerly told. Like those stories, these were self-aggrandizing, only now no one could take them seriously.

This man had slipped down the continuum, out of the normal range, and into the crazy range. And, yet, he was recognizable in each of these states as the man in the other one—the themes, the style, the goals of his speaking were similar. He was the same human being, only in one case he was in extremis, in an altered state of reality. That continuity is always present, no matter how psychotic a person becomes.

This man had slipped down the continuum, out of the normal range, and into the crazy range… yet, he was recognizable in each of these states…-Stanton Peele

But there is another continuity, outlined in Part I of this series, one that we should also always keep in mind. And that is, when the man was exaggerating his importance to feel better about his life, such self-inflation is something we all at times engage in. That is, his soon-to-be-psychotic behavior was of one piece with a common human impulse: we all want and strive—sometimes dysfunctionally—to feel important and loved.

This is part of the human condition. And, at different times, we all display the duality of the dysfunction of our traits while these same traits shore up our bedrock identities.

Charles was a hard-working, honorable family man, but not a very well-adjusted one. He separated from the mother of his boy and girl quite early in their marriage. Yet he never abandoned his family, always living nearby, paying his required child support and more, attending his kids’ sports and school events, taking them eagerly on his visitation days.

When his kids grew up, Charles was even more isolated. He lived alone in a small apartment over an auto repair shop in town. His kids—who loved him—nonetheless found Charles difficult to spend time with now that he couldn’t take them miniature golfing or swimming. He was not an easy man to be or talk with.

Charles had always been prone to bursts of energy, then lethargy. Now, in his forties, he embarked on a manic splurge…-Stanton Peele

Charles had always been prone to bursts of energy, then lethargy. Now, in his forties, he embarked on a manic splurge like no one had ever seen him on before. He barely slept, running around town, making angry, frightening threats against no one in particular, but also his family and other residents of the town.

Charles’ social worker and a psychiatrist labeled these outbursts paranoid delusions. Charles felt he could count on no one, including a court-appointed attorney selected to help him through legal difficulties he created in his manic state. Nor did he cotton to the psychiatrist who was supposed to manage his mental illness—partly because she saw him as so abnormal.

His kids were likewise wary about dealing with Charles. They loved him, but it was hard for them not feel that his crazy outbursts reflected badly on them as they, too, lived in this small community. Thus they tried to make clear that they were not a part of Charles’ life. His ex-wife wasn’t inclined to help Charles out. And even Charles’ mother, always distant and self-preoccupied (she had had multiple marriages), was nowhere to be found in this, his period of need.

Charles’ manic, psychotic state was thus a natural outgrowth of his previous existence.-Stanton Peele

Charles’ manic, psychotic state was thus a natural outgrowth of his previous existence. In both his crazy state and his earlier life he felt acute alienation and expressed feelings of aloneness. In his psychotic state he gave these feelings free, unbridled expression, further alienating his relations and strangers alike. And, yet, he didn’t want to give up his manic state. Like the case of meth addiction Ilse Thompson and I begin our book Recover! with, Charles felt that his mania was essential. Yet it could only be maintained so long, and its aftermath was shocking.

And, so, we see Charles as a unitary being, his crazy and normal selves different expressions of the same essential person. It is important—for both our and Charles’ humanity, as well as for our ability to help Charles and for him to emerge from his psychosis—to recognize the integrity of this human being that is centered on Charles’ basic identity. This identity is the key to knowing and to helping Charles, the source of his problems and his route to mental health.



How to Talk to Crazy People is a three-part article series by Stanton Peele. Check back for Part III: When and How Do You Help Crazy People?



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The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of Rehabs.com. We do believe in healthy dialogue on all topics and we welcome the opinions of our professional contributors.

What Are Your Thoughts on this Topic?

  • http://AddictionMyth.com/ AddictionMyth

    To put it differently, even a ‘psychotic state’ has a rational explanation if you take the time to understand it. It doesn’t mean there’s a ‘chemical imbalance’ which is really just medieval humoralism. Yes we all want to “feel important and loved” and bad things happen if we are not able to deal with the disappointment of not having that. The medicalization of mental anguish can make the problem worse, both in a self-fulfilling way and by increasing the stigma.

  • LizP

    I agree there is a continuum, no clear line between “normal” and “mentally ill.” But why does Peele have to use the word “crazy?” I’m glad he isn’t my doctor! I don’t even really like the term “mentally ill.” It is more a state of distress, sometimes not even so much for the individual as for the uncomfortable way they make others feel. It also has to do with how well one can carry out daily activities, relate to others, etc. Sometimes it’s pretty much lifelong, and sometimes it’s more situational. Like Peele said, the states can vary. It is still the same person. Sadly, people who have any kind of mental problems are often abandoned by family and friends, making their problems worse. Yet there are people whom we can’t be around for our own physical and/or mental health, even if we may feel sorry for them. We can’t always help them either.