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August 2, 1947

The Philosophy of Insanity

JAMA. 1947;134(14):1207. doi:10.1001/jama.1947.02880310065028

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This remarkable autobiographic commentary was written in 1860 by an anonymous recovered psychotic patient. Dr. Fromm-Reichmann, interested in exposing the thesis that the psychologic experiences and modes of expression of psychotic, neurotic and "so-called normal" individuals differ not in kind but in degree, has uncovered this work, which offers impressive support to her thesis. While the author, a layman, reflects in his writing a number of the misconceptions current to the psychiatric thinking of his time, his concept of mental disorder is in greatmeasure in keeping with modern thinking. He insists that "the line that separates sanity from insanity is invisible, and there are as many kinds and degrees of the disease as there are sufferers."

The description of the delusional mental state during recovery from a manic attack has the peculiar quality dependent on the intense suffering experienced by the the writer. His remarks on the care of the

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