**10. Conclusion**

Historically, the concept of insight in psychosis has evolved over time from being part of the very definition of psychosis to being an independent, modifiable aspect of the experience of a patient with psychosis. There has also been an evolution in the understanding of insight from a unitary to a multidimensional construct, with each component being influenced by various biological, individual and cultural factors. The study and understanding of such a complex, multidimensional concept needs to be carried out at various levels and with needed emphasis on the personal and interpersonal aspects of the people suffering with psychotic disorders, aspects that are routinely neglected in the clinical discourse in favor of reductionist biological models.

While exciting neurobiological research seems to indicate that certain aspects of insight in psychosis may be biologically driven, it can no longer be justifiably considered a unitary construct. Individual and sociocultural factors play a key role in insight. "Acceptance of mental illness as the cause of symptoms" and "acceptance of treatment" are both factors that may be significantly colored by one's pre-morbid personality, worldview and cultural background. A patient who is able to recognize symptoms as being abnormal experiences and attempts to organize his experience in a meaningful way leading to help-seeking should be considered as having good insight into his illness even if the explanation and treatments he espouses differ from biomedical ones. An imposition of biomedical models into the definition of insight may not only alienate patients from other cultural backgrounds from approaching treatment, it may also impede accurate clinical judgment by making the assessment of this crucial aspect of illness incomplete.

Fundamental to any effort to understand higher aspects of human experience (such as delusions and insight into illness) is an adequate understanding of the nature of human personhood. Taking after Kraepelinian descriptive psychopathology, biological psychiatry has tended towards reductionist understandings of personhood that emphasize neurobiology and symptoms of illness. We suggest that the more holistic Jasperian phenomenological approach to psychopathology which emphasizes both the "erklaren" (descriptive and causal explanations) and "verstehen" (empathic understanding) aspects of psychopathological assessment is a better reflection of the complexities that make up the human condition. Such a holistic, integrated understanding of the concept of insight in psychosis would in turn guide the therapeutic, administrative and legal management of people with these debilitating illnesses.
