What We Talk About When We Talk About Insight

The insight construct has an important place in humanistic psychology and psychiatry and has stimulated considerable research in the last 4 decades although its history extends much further back. However, it has also been criticised in recent years for being overly reliant on a ‘medical model’ of illness and reductionist. Furthermore, its invocation in medicolegal settings where involuntary treatment and capacity are adjudicated has been viewed as circular and detrimental to patients. This article is my personal attempt to expand upon the insight construct with reference to how it is actually used in clinical contexts – with examples – in a way that might reassure critics of its value. The relationship between insight and anosognosia, ‘agreeing with the doctor’, delusions, decision-making capacity and treatment compliance are each considered. I conclude that the concept of insight should be considered a worthwhile topic in medical education. I proposed that it be seen as expansionist, connected to patient narratives and metacognition, and a positive element in the personal growth of people with serious mental disorders.