Insight

Insight was once described as ‘academically nourishing but clinically sterile’. Yet few worthwhile discussions in clinical psychiatry omit consideration of insight. It is worthwhile because, in people with psychosis, it predicts clinical and functional outcome, coercion and capacity, mood and cognition. Some dismiss it as mere agreeing with the doctor; more ‘us and them’. Poet Robbie Burns (1759–1796) asks God to give us the gift ‘to see oursels as others see us’, ending denial of our imperfections and unwillingness to turn our gaze upon them. Thinking about insight demands we view ourselves and our flawed humanity critically. We are all a bit ‘us’ and ‘them’.