Normal & Abnormal within the Psychoanalytical, Biological, Behavioral, Cognitive, Sociocultural & Humanist perspectives
The definition of mental illnesses is a complex and controversial subject, where there is no universal consensus yet. The disagreements are not only at the level of different perspectives such as psychoanalytical, medical, socio-cultural, etc, but are evident within them as well. Since mental illnesses don’t lend themselves to physiologic proofs such as blood tests or scans, the psychiatrist/psychologist has to resort to evaluation methods such as questionnaires, personal interviews and other indirect methods of arriving at an inference. The drawback with such methods is that they are not precise and subject to interpretation and presentation, which can compound errors. Moreover, there is no consensus when it comes to definition of several major mental illnesses. Definitions of normality and abnormality in mental health have proven to be abstract, inconclusive and have elicited contestation. Take say, the example of Adjustment disorder, which occupies a peculiar position in the diagnostic system of the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000). The manual shows Adjustment disorder as “straddling the boundary between normal and abnormal psychology”. (Daniels, 2009) In contrast, a more human-centered approach in counseling (as espoused by the
Psychological illness being a somewhat contested concept has led to ambiguity in interpretation and drawing of definitions. On the one hand, “the normal may be thought of simply as the typical or common. On the other hand, it is sometimes intended normatively or evaluatively”. (Dupre, 1998) The interplay between these usages is captured in the dictionary. For example, one dictionary has the following list of explanations for the word ‘normal’: “1. conforming to the standard or the common type; usual; regular; natural; 2. serving to fix a standard; 3. of natural occurrence; 4. approximately average in any psychological trait, as intelligence, personality, or emotional adjustment; 5. free from any mental disorder; sane; 6. free from disease or malformation.” (Dupre, 1998) The ambiguity in the general understanding of ‘normal’ is only more pronounced across different analytic frameworks such as cognitive, behavioral, humanistic, socio-cultural, etc.
Some of the major psychological disorders currently include Anxiety, Phobia, Panic Disorder, Depression, Schizophrenia, Personality Disturbances, Psycho-Somatic illnesses, etc. In most cases, an individual diagnosed with any of these disorders also carries symptoms of other related disorders. For example, those who suffer from Major Depression are also likely to carry symptoms of anxiety and panic to varying degrees. Similarly, those suffering from Schizophrenia are prone to have personality disturbances. In this way, there is continuity and overlap among commonly labeled psychological illnesses.
The implications of labeling behaviors as either normal or abnormal can be far-reaching for both the individual and the society. The main area of concern is stigmatization, for common people don’t have a proper understanding of what different mental illnesses entail. Historically, people carrying mental illnesses were loosely classified as ‘insane’, with all the attendant negative connotations for the term. But in truth, not all mental illnesses can be related to insanity, and in most cases, a bout of illness is transient and temporary. For example, a bereaved husband who has lost his wife can be expected to fall into depression. But it is unlikely that the person is characteristically depressive. In this case, his depression is a proper and normal response to the situation. It is also a well documented fact that most creative artists are temperamentally volatile and prone to display signs of bipolar mood disorder. The British comedian Stephen Fry has stated that his creative output increases greatly during the manic cycles only to dry up during the depressive episodes. This case illustrates the danger in labeling psychological behavior as normal and abnormal. (Daniels, 2009)
The classification certain mental traits as abnormal have in recent decades attracted criticism. This is especially true with respect to certain high achievers in art, science and literature, whose exceptional talents in their chosen field has correlated with deficiencies in other aspects. For example, the Nobel Prize winner for Mathematics John Nash is famous for both his mathematical genius and his lifelong schizophrenia. Going back a few centuries, Isaac Newton, one of the most influential physicists, was notorious for his socially reclusive lifestyle and pronounced introversion. Many great writers of the twentieth century, including Graham Greene, Joseph Conrad, Iris Murdoch, etc suffered regular bouts of depression. Could abnormality be bad if it leads to such great creative output? Hence, labels such as normal and abnormal could at best be vague indications and at worst be totally irrelevant. Considering that society still attaches stigma to psychological disorders, one should exercise caution and judiciousness before using such labels.
Some of the most common psychological disorders presently include anxiety, phobia, panic attacks, major depression, bipolar depression, schizophrenia, psycho-somatic illnesses, personality disturbances, etc. A dominant diagnostic paradigm in acceptance today is that most of these conditions are induced by neuro-chemical deficiencies that could be rectified through oral intake of medicine. Anti-anxiety medications, antidepressants such as Prozac, Zoloft, Wellbutrin and other anti-psychotic medicines have become part of common parlance. Each year, mental health professionals write millions of prescriptions for these drugs. But the effectiveness and safety of these drugs are highly contested. One of the main criticisms leveled against these medicines are their poorly designed trial runs which last a mere six weeks. Obviously, it is impossible to predict the long term effects on a patient based on the results of a six week trial. Moreover, many of the side effects of these drugs are either suppressed or underplayed, leading to adverse reactions in unwary consumers.