MADMEN: "Madman" isn't a technical term!

MONDAY, FEBRUARY 3, 2025

The silence has been a surrender: A far as we know, "madman" isn't, and has never been, a technical clinical term.

As far as we know, it isn't a term that's used within the fields of psychiatry or psychology. As far as we know, it isn't a term that's used within any branch of medical science.

"Madman" is a term of art—a part of colloquial discourse. As far as we know, no one in the medical field ever says that Person X is a madman, or even a madwoman, not even if the person in question lives in Chaillot, a part of Paris, France. 

(In French, the corresponding term seems to be "la folle." As far as we know, medical practitioners never use that term.)

"Madman" is a part of colloquial discourse. In its place, medical practitioners might be inclined to say that some such person is "mentally ill"—or then again, possibly not! Consider what we learn from the planet's leading authority on matters of mental health.

That authority does offer a lengthy discussion which carries this heading: "Mental health." That said, the same authority offers no corresponding submission headlined as "Mental illness."

Instead, the authority matches its lengthy entry on "Mental health" with an equally lengthy entry on "Mental disorder." Regarding the term in question, the reader is quickly told this:

Mental disorder

A mental disorder, also referred to as a mental illness, a mental health condition, or a psychiatric disability, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. A mental disorder is also characterized by a clinically significant disturbance in an individual's cognition, emotional regulation, or behavior, often in a social context. Such disturbances may occur as single episodes, may be persistent, or may be relapsing–remitting. There are many different types of mental disorders, with signs and symptoms that vary widely between specific disorders. A mental disorder is one aspect of mental health.

The causes of mental disorders are often unclear...

According to that passage, a "mental disorder" is also referred to, presumably by medical specialists, as a "mental illness." Somewhat similarly, the reader is also quickly told this, right there at the start of paragraphs 5-7 of the submission in question:

The definition and classification of mental disorders are key issues for researchers as well as service providers and those who may be diagnosed. For a mental state to be classified as a disorder, it generally needs to cause dysfunction. Most international clinical documents use the term mental "disorder," while "illness" is also common. 

According to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), published in 1994, a mental disorder is a psychological syndrome or pattern that is associated with distress (e.g., via a painful symptom), disability (impairment in one or more important areas of functioning), increased risk of death, or causes a significant loss of autonomy; however, it excludes normal responses such as the grief from loss of a loved one and also excludes deviant behavior for political, religious, or societal reasons not arising from a dysfunction in the individual.

DSM-IV predicates the definition with caveats, stating that, as in the case with many medical terms, mental disorder "lacks a consistent operational definition that covers all situations," noting that different levels of abstraction can be used for medical definitions, including pathology, symptomology, deviance from a normal range, or etiology, and that the same is true for mental disorders, so that sometimes one type of definition is appropriate and sometimes another, depending on the situation.

Even this early in the discussion, it's getting complex in here! 

That said, it sounds like there's nothing "wrong" with the familiar term, "mental illness." On the other hand, we're told that the alternate term, "mental disorder," is used more frequently around the world.

It still sounds like either term is pretty much OK. However, if you click ahead to another long entry within that same authoritative source, the reader is now told something different. 

Below, you see language from that third lengthy entry, an entry whose heading is shown below:

Classification of mental disorders

The classification of mental disorders, also known as psychiatric nosology or psychiatric taxonomy, is central to the practice of psychiatry and other mental health professions.

The two most widely used psychiatric classification systems are chapter V of the International Classification of Diseases, 10th edition (ICD-10), produced by the World Health Organization (WHO); and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), produced by the American Psychiatric Association (APA).

[...]

Most international clinical documents avoid the term "mental illness," preferring the term "mental disorder." However, some use "mental illness" as the main overarching term to encompass mental disorders. Some consumer/survivor movement organizations oppose use of the term "mental illness" on the grounds that it supports the dominance of a medical model. The term "serious mental impairment" (SMI) is sometimes used to refer to more severe and long-lasting disorders while "mental health problems" may be used as a broader term, or to refer only to milder or more transient issues. Confusion often surrounds the ways and contexts in which these terms are used.

At long last, our guide has acknowledged a bit of "confusion" surrounding the complexities of the conceptual wilderness into which we've now agreed to wander. Beyond that, we're also told that most international clinical documents avoid the term "mental illness!" 

Most clinical documents avoid that term! In some venues, the term "serious mental impairment (SMI)" may be preferred, we're now told. 

Alas! As with everything else in our struggling world, "Confusion often surrounds the ways and contexts in which these terms are used." 

The confusion and complexity seem to be general, or so it now seems we've been told. And that's certainly true within the world of American journalism with respect to the concepts at hand.

In the world of American journalism, practitioners routinely speak of "mental illness" when discussing certain types of behaviors, including instances of violent "street crimes" committed by people who are said to be homeless, or who are perhaps unhoused. 

On the other hand, practitioners never speak of "mental illness" when discussing the peculiar behaviors and crazy statements of major public officials. For better or for worse, it simply isn't done.

For better or worse, our journalists don't speak of "mental illness" with respect to such people—and they don't speak of "mental disorders" either. With respect to such prominent people, the use of such language has long been forbidden by the unwritten rules of the guild.

Does "mental illness" (or some such condition) even exist in the world? We may briefly sample that question before the week is done.

But according to journalistic tradition, no such condition can be said to exist in the world of major public officials. That's true no matter how wildly disordered their behaviors, and their endless public statements, may endlessly seem to be.

No major public official can be said to be gripped by a mental illness, or even by a mental disorder! Similarly, no such person can be said to be a madman, or even a nutcase or nut.

Such prohibitions may be creating a major problem with respect to the public discussion of some current public officials. For example, is it possible that Elon Musk is a clinical nutcase? Is it possible that the current commander, Donald J. Trump, fits within that same rubric?

For the record, the questions we're asking are totally academic—are totally theoretical. No such behavior will ever emerge within the mainstream press, no matter how disordered the behavior of these people may seem to become.

Our questions are purely theoretical. At most, someone will be "telling this with a sigh / Somewhere ages and ages hence."

With that basic point acknowledged, is it actually possible? Is it possible that a major, well-known public official could be gripped by a "mental disorder?" 

A system-wide silence has been maintained with respect to such questions. That system-wide silence is being maintained even now, as it starts to look like the nighttime assault has begun. 

The system-wide silence is being maintained. We'll close today with one more theoretical question:

Is it possible that the refusal to ask such obvious questions will qualify, in the end, as yet another "mental disorder" within this vale of tears?

Tomorrow: We expect to lose most of the day tomorrow. For a tiny overview of our (purely theoretical) concerns about the commander and the satrap, see this afternoon's report.

("A satrap served as a viceroy to the king, though with considerable autonomy." If you doubt that representation, you can just click here.)