The Definition of Insanity
“The definition of insanity is doing the same thing over and over and expecting different results.” - author unknown
This quote is often attributed to Albert Einstein, but there is no evidence he ever uttered the phrase. I have heard this “truth” repeated ad nauseam throughout my career to describe the process of addiction. I have heard it in clinical settings, in support meetings, in rehabs, in supervision, in homeless shelters.
The problem with the statement is that it is wrong. Dangerously wrong. On many levels.
First of all, doing things over and over again is exactly how the brain works. There is a behavior that produces a positive chemical response. Even if the next 20 experiences produce a negative reaction, the brain has a solid memory of the “win.” Are you familiar with Las Vegas? It exists because of this principle. Some casino games have better odds than others. If you can find a single deck game of blackjack the house still has a .13% edge over the player. But if you’ve played, you know the feeling of hitting Blackjack. It’s quite a thrill. The brain is designed to work this way. Dopamine is released in order to produce a memory or a marker, reminding the brain how to repeat the behavior (when you do “this” you get “that”). That’s why we don’t have to think too hard about how we eat. The brain relies on repetition. Imagine trying to learn how to tie your shoes daily. Or how to walk. We are humans. We do things over and over and over. And sometimes, we do so expecting different results. We break up and we get back together. We give people second chances. We might get sick on seafood, but eventually we add it back into our diet. Why? We like it. Specifically, our brains like it. We tend to circle back to the things our brains like.
The second reason, the main reason, this “truth” is so dangerous is that it aligns the person with a Substance Use Disorder with insanity. This statement lives without scrutiny in “the Rooms.” The actual definition of insanity is this: Not of sound mind. Mentally deranged. Out of touch with reality. When we use the quote at the top of the page to describe a person’s behavior with a substance use issue we are calling them deranged. Incapable of making sound judgments. You and I might look at their behavior and decide they are making poor choices with their lives. But that would be both uninformed and unhelpful. Have you ever known someone to become un-deranged (yes, I know that’s not a word) by simply declaring they were deranged? Doubtful. I have known people, however, who were so despondent over their state of insanity that they simply gave up the fight. When everyone around you thinks you are insane then it starts to become part of your identity.
(Sidebar: This isn’t a critique of AA. Many of my friends owe their lives to that support system. AA is certainly one way people have found recovery through the years. But it’s not for everybody and it’s not treatment and it’s not the only way.)
I have seen emergency room physicians withhold medication from overdose patients to “teach them a lesson.” I have watched family members facilitate “rock bottom” under the guise of not enabling, when the reality is that the family’s behavior was more about punishing than helping.
So, fair warning, I’ll interrupt you when you begin a sentence with, “You know the definition of insanity is…”. The definition of insanity is repeating definitions of insanity that are not helping anyone.
