Max Littman, LCSW
April 22, 2026
The phrase “the definition of insanity is doing the same thing over and over again and expecting a different outcome” is repeated often enough in the mental health field that it starts to sound like an established truth.
Someone reaches out to the same person for understanding and leaves the conversation feeling dismissed again. A woman goes into a meeting hoping it will be different this time and notices the same tightening in her body as it unfolds. A marginalized person trusts that a system will respond with care and finds themselves navigating the same gaps and misattunements. A daughter tries to explain to her father something that matters and watches it not land in a familiar way. All would be defined as “insane”.
This definition is concise, sharp, and carries an implied judgment that can feel clarifying in the moment, which may be part of why it circulates so easily.
When this definition is held up against how parts actually organize experience, the pattern starts to look different.
When someone repeats a behavior that doesn’t seem to lead to the desired outcome, there is usually a part of the system that has a vested interest in continuing. These parts are organized around burdens: the unspeakable, often hard-to-name emotions, beliefs, and somatic experiences that form when significant human needs are not met within a relationship, whether in a single intense moment or over time.The repetition isn’t random. It’s structured around beliefs, emotions, and expectations that were taken on in earlier experiences and are still shaping what feels possible.
Parts organized around burdens often operate with a very narrow range of options. Some don’t register that something different could happen. Some are oriented to a different time period and continue to respond as if those conditions are still in place. What is happening in the present does not always register, and when it does, it isn’t always taken in.
When we consider that context, repetition can be an attempt to make something happen that never did. To have a human need met by the exact person or people who did not meet it in the moments the burden formed. Parts can find themselves pulled toward people and situations that resemble those earlier conditions, often without much awareness of it. They look for repair, completion, and arrival to a different ending using the same set of moves. The pattern can hold even when it repeatedly leads to the same outcome.
There is a logic to it when we look more closely, more compassionately, and with more curiosity. Our internal system is organized in a way that keeps producing what is already known. A different outcome can be outside what the part can imagine. It can also feel destabilizing. It can challenge beliefs that have held our system together and saved our lives, even if those beliefs are painful.
So the repetition continues. New information isn’t always integrated. The pattern reflects a continuation of a burdened internal organization.
There’s another layer here around what is happening externally, and how people sort out what is coming from inside and what is happening around them.
Sometimes the repetition of behaviors and outcomes is not only internal. Something in the external world is actually happening again and again. A boss who singles someone out in ways that feel targeted. A caregiver who continues to cross a line. A system of care that stays disorganized or unresponsive in ways that keep landing on the same people. An institution that reproduces the same pattern, whether or not it is attempting to address it.
When I notice those moments in others, I find myself saying, in a straightforward way, that they’re not crazy or insane for seeing a pattern. The pattern may in fact be there. Their system is responding to something that is happening, not only to something that happened before.
And I notice I sometimes want that reflected back to me as well. I want a sanity check.
When something keeps repeating externally, especially in a way that feels violating or diminishing, it can start to create doubt inside. Parts can turn toward self-questioning. Am I misreading this? Am I overreacting? Is this actually happening the way it seems to be happening? Am I crazy? Am I insane?
The repetition in the environment can blur with the repetition inside.
Burdened parts can get more disoriented when the external conditions are real and not coming from earlier experiences, whether personal or carried through family or culture. Naming what is actually happening, and how off or destabilizing it is, can help parts orient and take something in.
From there, the system is still left with the question of how to respond to something that may not change, or may change slowly, or unpredictably.
And that question doesn’t always have a clean answer. Some orientation can still help.
Coming back to the internal pattern, “expecting a different outcome” doesn’t fully describe what’s happening inside. Some parts do hope for a different outcome. Some anticipate the same result. Some move forward without much expectation of a different outcome because the action itself serves a role within the system.
The word “insanity” adds another layer. I find myself thinking about how “insane” and “crazy” get used interchangeably. They aren’t identical, but they often function in similar ways, especially when directed toward vulnerable people whose reactions are shaped by burdens.
When either word is applied to a person, it compresses what is happening inside a burdened system into something global. The internal logic of parts falls away, and what remains is a sense that something or someone is simply wrong, sick, broken, or repelling.
At the same time, the word “crazy” shows up differently in everyday language. Saying “this is driving me crazy” often points to overwhelm, strain, or the feeling of being pulled in multiple directions internally. It reflects pressure on the system rather than a fixed identity.
Coming back to the idea of a “sanity check,” naming this can help a system orient to what is happening, instead of turning toward doubt about whether the perception is coming from something earlier.
There are moments when our internal system feels crowded, when burdened parts are activated in quick succession, when the same situation keeps touching the same intrapsychic material. From the outside, it can look repetitive. From the inside, it can feel like something is still unresolved and still organizing behavior.
Sometimes awareness of the repetition shifts something. Sometimes it doesn’t. Sometimes the repetition continues, even when it’s been named and understood differently.
And sometimes, even within that, a part begins to take in something new. And maybe something loosens.
For feedback and comments, I can be reached at max@maxlittman.com.
I provide consultation and therapy for therapists.
Purchase my new book IFS Therapy for Gay and Queer Men here.
