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Who is Normal or Abnormal

Anthropological work in non-Western cultures suggests that there are many cases of behavior that psychiatry would classify as symptomatic of mental disorder, which are not seen within their own cultures as signs of mental illness.

Normal and Abnormal

‘Norm’, in the strict sense is a kind of statistical average, which can be calculated. But being ‘average’ is not what the term ‘normal’ conveys in a psychological context. In a broader sense, we think of a person who is normal as someone who is generally healthy, i.e., not disturbed.

The medical model for determining what is normal is clearly distinct from the psychological one. In medicine, another frame of reference is used: for example, take body temperature in which there is a clear normal range and any measurement following outside of this is deviant and ‘abnormal’. But it is not always so clear that behavior that deviates from the ‘norm’ or average behavior is necessarily abnormal or unhealthy. In many instances it may be superior to the ‘merely’ normal or average, i.e. run of the mill activity.

Traditional practitioners, used to stress the patient’s adjustment to the prevalent society as “normal”. The classical view in psychology is that individuals must adjust to society. Those who do this well and are able to ‘fit in’ are declared healthy. And the others, who are less adept at conforming to society’s rules, …well, they are disturbed, or neurotic, or abnormal, or whatever labels the traditionalist may use.

Most attempts to describe abnormality are based on one or more of the following definitions.

Firstly, abnormality can be defined as a deviation from statistical norms. This definition of abnormality is based on statistical frequency: abnormal behaviour is statistically infrequent or deviant from the norm. But according to this definition, a person who is extremely intelligent or extremely happy would be classified as abnormal. Hence, other definitions should also be considered.

Secondly, abnormality can be defined as a deviation from social norms. Every society has certain standards or norms, for acceptable behaviour; behavior that deviates markedly from these norms is considered abnormal. However, as different societies have different social norms and these may change over time, this point cannot be considered in isolation. .

Maladaptiveness of behaviour also defines abnormality. Behavior is abnormal when it is maladaptive, if it has adverse effects on the individual or on the society.

Finally, abnormality can be defined in terms of the individual’s subjective feelings of distress rather than the individual’s behaviour. Sometimes personal distress may be the only symptom of abnormality; the individual’s behavior may appear normal to the casual observer.

None of these definitions, however, provides a completely satisfactory description of abnormal behaviour.

Fritz Perls had an unusual perspective on this question. He offered the radical notion that in our modern society, no one is really healthy. Some people are ‘sick’ in the common way i.e. they have no ideas of their own slavishly following the latest trend, while others are disturbed in their own peculiar, idiosyncratic way. But all of us are ‘unhealthy’ in the sense that no one is truly fulfilling his potential. In fact, Perls believes that most people utilize only a small proportion of their total capacity; He considers a man who uses 25% of his ability, a genius.

For the modern therapist, people with behavior disorders are not judged ill merely because they are out of step with society; they are considered in need of help because they are out of touch with themselves.

Whatever may be the definition we know today that disorders of thinking and behavior are biologically based disorders of the brain . They cannot be overcome through "will power" and are not related to a person's "character".

Like Diabetes is a disorder of the pancreas interfering with sugar metabolism, imbalance in body and brain chemistry interferes with mental health and influences how we behave. Today we have effective medicines with little or no side effects for treatment of many behavioral disorders (see sample list); once the thought process is stabilized with medicines, psychotherapy may be used. 70 to 90% of individuals have significant symptom reduction and improved quality of life with treatment. Early identification and treatment results in quick recovery and minimizes further harm.

An attempt at Distinction:

To bring some amount of clarity to this confusion, I personally prefer to distinguish between mental illness, mental disorder, mental distress and mental ill-being. All of these can be covered under the umbrella term “mental ill-health.

Illness is a state of poor health resulting from disease, and mental illness (commonly known as psychosis) is a state of disruption of mental health caused by neuro-chemical imbalances in the brain that result in behavior that is destructive to self and others.

Thus the mentally ill person begins to lose touch with reality and begins to live in a world of his own mental creation and is unable to function in this world of ours. He/she requires medication to correct the neuro-chemical imbalances in the brain and restore mental health.

The current prevalence estimate in adults is that about 5 percent of the population is affected by mental illness. This category includes illnesses such as schizophrenia, bipolar disorder, and other severe forms of depression; This estimate is stable across geographic and cultural boundaries and gender.

Disorder is defined as “lack of order or regular arrangement”. A condition is a disorder if and only if (a) the condition causes some harm or deprivation of benefit to the person as judged by the standards of the person's culture (the value criterion), and (b) the condition results from the inability of some internal mechanism to perform its natural function. So I prefer to use the term mental disorder to refer to a lack of orderly thinking and emotional instability (commonly known as neurosis) that is caused by unconscious or repressed thoughts and emotions. A person with mental disorder is completely in touch with reality yet finds that he/she experiences mental suffering without being aware of any event that triggered it. They are able to function in this world but not as they would like to. He/she requires professional help to unearth the buried thought / emotion that is triggering the emotional disturbance.

The current adult prevalence estimate is that about 20 to 30 percent of the population is affected by such mental disorders. This category includes illnesses such as severe anxiety, panic, Obsessive-compulsive disorder etc. This estimate also is stable across geographic and cultural boundaries. Features of mental disorders are similar across genders, although diagnosis of the disorders occurs more than twice as often in women as in men.

The prevalence rates for mental illness and mental disorder in children are similar to those of adults

Distress is “ to cause strain, anxiety, or suffering to”. A person has a distress if and only if he has a condition, other than his rational beliefs and desires, such that he is suffering, or at increased risk of suffering, an evil (death, pain, disability, loss of freedom or opportunity, or loss of pleasure) in the presence of a distinct sustaining cause. Thus the term mental distress can be applied to emotions that cause suffering in response to environmental (both internal and external) stimuli. A person with mental distress is in touch with reality, is able to function in this world as he/she would like to but experiences mental suffering in response to some event, that he/she is aware of but is unable to cope with. Removal of the event causing distress or learning to cope with it alleviates the distress

Well-being is defined as “the state of being healthy, and happy”, and the term mental ill-being refers to a feeling of not being quite healthy or happy in the absence of illness, disorder, or distress. A person with mental ill-being is in touch with reality, able to function in this world as he/she would like to, experiences NO mental suffering, yet does not feel quite happy or healthy. Such a person requires to find a meaning or purpose in life.

The purpose of this Website is to promote public awareness about mental health

The contents of this site are for informational purposes. Nothing contained in this site is or should be considered or used as a substitute for professional medical or mental health advice, diagnosis, or treatment. Never disregard medical advice from your doctor or delay seeking it because of what you have read.

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