Just about any ordinary person can slip into madness, believes APA President Philip G. Zimbardo, PhD. In fact, all it may take to trigger the process is a special kind of blow to one's self-image to push someone over the edge of sanity.

"My colleagues and I have demonstrated that situational forces...can generate surprisingly powerful contributions to make good people behave in bad ways," he said to a standing-room-only crowd in his presentation, "Why and how normal people go mad," at APA's 2002 Annual Convention in Chicago.

The basis for his ideas is his discontinuity theory, which posits that when people perceive a violation in some domain of functioning vital to their sense of self-esteem, they will search for ways to explain or rationalize the experience. An A-student who suddenly gets poor grades, for example, may develop sexual or eating problems, or exhibit violent fantasies--symptoms that could warrant a clinical diagnosis of psychopathology. But, according to Zimbardo's theory, many people who exhibit symptoms of "madness" are "reasoning with insufficient data or rigidly defending the wrong theory," he said. As Zimbardo pointed out to attendees, Voltaire said, "What is madness? To have erroneous perceptions and to reason correctly from them."

False cues

Sometimes, Zimbardo said, the source of a person's discontinuity can be physical but mistakenly attributed to a psychological disorder. "Think of this," he said. "You're going deaf but aren't really aware of it. You walk into a room full of friends and you see their mouths moving, but you don't hear them. You ask, 'Why are you whispering?' and they say 'We're not whispering.' You say, 'Why are you lying?' and then you end up in a confrontation and people think, 'Gee, this guy is really crazy.'" That process can produce paranoid delusions, he noted.

But many people deemed "crazy" might not be crazy after all, he said. A 1989 study (Koran, Archives of General Psychiatry) of 500 patients in several California state mental hospitals showed a large percentage had physical diseases that could cause or exacerbate a mental disorder--yet they were not detected by professionals.

Could some of these patients' psychological disturbances have been explained by medical problems and thus "cured"? Zimbardo asked. And why is the real root of what seems to be pathological behavior undetected or ignored?

So too, prevailing societal biases may mask the root cause of "mad" behavior. Take for example the "witches" in Salem, Mass., who shared a diet based on rye grain, which in wet, cold climates like that of 1692, grew a fungus that produced a natural hallucinogen, like LSD. The girls probably weren't mad, just suffering from microbiological food poisoning. Society offered witchcraft as a readily available explanation for these discontinuities, Zimbardo pointed out.

Recent research

Zimbardo and his colleagues at Stanford University tested his theory on normal, healthy, hypnotized college students. In their study, the researchers generated a discontinuity--they induced sudden increases in heart rate and respiration that created unexplained arousal characterized by feelings such as anxiety, anger, nervousness or restlessness--in these student volunteers. The volunteers were then guided to incorrectly attribute the cause of their problem through potential cognitive, environmental or social explanations for the discontinuity, as suggested by the researchers. In effect, they duped the students into believing the wrong reasons for their discontinuity.

Zimbardo predicted that when the volunteers were unable to come up with acceptable explanations or social comparisons for their arousal, their inability to deal with it would eventually lead to predictable symptoms of psychopathology. He was right. When volunteers incorrectly blamed situational or environmental factors for their arousal, they began to exhibit phobic behaviors. When students were led to wrongly believe that the source of their anxiety was physical, they began to show signs of hypochondria or somatoform disorders. And attributing such discontinuities to social causes created paranoid symptoms.

Similarly, in earlier research he and colleagues have done, Zimbardo noted, hypnotically induced unexplained deafness in volunteers generated experimental paranoia. Like the volunteers themselves, therapists involved as raters in the experiments who were asked to determine the cause for the volunteers' symptoms mistakenly attributed the behaviors to varying clinical conditions.

"The seeds of madness," said Zimbardo, "can be planted in anyone's backyard." But "mad" behavior may not necessarily be the product of "some 'premorbid' personality disorder," he noted. Psychologists would do well to consider physical, situational and societal influences--and the timing of these influences--in their work with patients.

"Madness is the sufferer's unintentional disruption of society's norms, of reasonable and normal actions," he said.