Because a clear sense of identity is a necessary condition for adequate mental functioning, malformation of identity leads to discomfort with one s self and social maladjustment, reaching clinical proportions among the more fragile of us. That is why the addition of madness to the roster of familiar mental illnesses coincided with the emergence of nationalism.

Madness expressed itself in degrees of mental impairment, the common symptoms of which were chronic discomfort in one s environment (social maladjustment), uncertainty about oneself, oscillation between self loathing and megalomania, and sometimes a complete loss of identity. Suicide became common, and the nature of violent crime changed, with a new type irrational and unconnected to self interest becoming increasingly prevalent.