The Medical Model for Treating Mental "Disorders"
We Teach People How to Treat Us

How do we define "abnormal" behavior?

Years ago (we won't discuss how many), I sat in my first abnormal psychology class.  The professor described the medical model for diagnosing mental illness, explained that mental illness was viewed as behavior that is abnormal, then raised a question for thought,  "But how do we determine what is "normal" and "abnormal" human behavior? 

Should we call immoral behavior "abnormal"?  If so, whose morality shall we apply?  Some cultures believe in many having multiple wives, some consider it immoral.  Some cultures allow alcoholic beverages, some consider it immoral.  Some cultures eat beef, some cultures belief that cows are sacred and eating beef is immoral.  Which version of morality would constitute normalcy?

Should we call unusual behavior "abnormal"?  Unusual for whom?  Some people find piercings to be unusual, some don't.  Some people consider it unusual to hear voices or see things which are not there.  Others consider this to be a spiritual experience.  Psychologists believe that a number of famous creative luminaries, including Vincent Van Gogh, Albert Einstein, Emily Dickinson and Isaac Newton, had schizotypal personalities.  What if they had been forced to be more "normal"?  How would this have affected their creativity?  For a look at how antipsychotic medications affect creativity see my article, "The Schizophrenic Artist". 

Should we call unusual beliefs "abnormal"?  One man's religion can be another's "abnormal" beliefs.  David Icke believes the world is ruled by descendants of reptilian humanoids. 

The professor suggested the following definition for identifying the point at which behaviors become "abnormal" and warrant psychological intervention:

When the client experiences the behavior as being problematic, or finds the behavior to be interfering with their functioning to the point they are unable to participate fully in their lives, as they define them.

Through the years I continue to find this definition to be helpful.  It is important to note that it is up to the client to determine when the behavior becomes a problem, not for other people.  I see people who insist that someone else needs to change their behavior.  There is a perfect example of this on TherapyDoc's blog where a person writes in to ask how to get a friend of hers to get on medication.  Clearly, she is uncomfortable with his behavior and experiences.  What I don't see is that he is uncomfortable with his behavior or experiences.

Let me first clarify how I define "functioning" as used in the definition above. 

Do they:

1) eat
2) sleep
3) interact with others as they wish to
4) work, as they define it
5) perform adequate self care, as they define it (i.e. hygiene, medical care)


But how does it work when applied?  Would you consider the following people "abnormal"? 

1.  A man wearing a dress

What if he is from the Arabian peninsula wearing a dishdahsa?
What if he is a successful female impersonator?
What if he is a Scotsman wearing a kilt?

2.  A person living in a tree

Consider this gentleman who lived full-time in a tree house while attending the University of California at Davis and now builds them for others.  Or this site

3.  Someone who is a "hermit"

People diagnosed with Schizoid Personality Disorder genuinely prefer to be alone and do not secretly wish for popularity. They tend to seek jobs that require little social contact. Their social skills are often weak and they do not show a need for attention or acceptance. They are perceived by others as humorless and distant and often are termed "loners."  However, they are quite content in being this way. 

Introverts are also quite content to be alone, and often prefer it.  This is a normal way of being.  Not everyone has to be a social butterfly. 

In the end, it all goes back to whether the person themselves considers it a problem.  The only two exceptions I would make to this general rule are:

1.  When someone who has ceased to function so completely that their life is in danger.
If they are failing to eat, sleep, tend to wounds or medical problems that are life threatening or they are engaging in other behavior which is life threatening an intervention might be warranted without their consent. 

2.  When someone is a danger to others, an intervention is warranted without their consent. 

However, if they are neither a threat to themselves or anyone else I believe that clients should be the ones to determine whether their behavior is "abnormal" or not and whether assistance is desired.

What do you think?  How do we determine what is "normal" and when behavior becomes "abnormal"?

Comments

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Tracy


I would rather cosider that: 'doing' the common daily things, not so common, as being abnormaal

Raul Espejo Rodarte

2.3.9.1 Enseñanzas especiales.
Cuando se encuentran alumnos con problemas conductuales atípicas, obligan a una atención especial por parte del docente, para lo cual no está preparado y no tiene tiempo.
Es una situación en dos vertientes, una la de los alumnos que carecen de las facultades requeridas para su desarrollo profesional, o el caso de aquellos estudiantes que definitivamente tienen una capacidad muy superior, para los que los estudios normales parecen sosos y lentos. Ambos casos constituyen un problema para el docente “normal” y para los que se encuentran en el caso de superiridad, francamente se desperdician sus talentos obligándolos a un comportamiento promedio (normal).
En la mayoría de los casos desfavorables, el sujeto presenta una notable mejoría cuando se le trata como a una persona “normal”.
2.3.9.2 Comportamiento Anormal
La distribución de probabilidad Normal plantea la explicación. Si, por ejemplo, nos limitamos al cociente intelectual (IQ) para adultos, se supone que tiene una distribución normal con media 100 y desviación estándar de 15 (mas o menos), más del 95% de la población se encuentra en el intervalo 70 a 130, por lo tanto debajo de ese intervalo o encima de él, se considera al sujeto “anormal”. Lo que sugiere el hecho de que el 5% de la población es anormal.
Afortunadamente en los niveles superiores de educación los alumnos han sido seleccionados por exámenes de admisión y por selección natural en los estadíso eductivos previos.
Los casos de drogadicción o traumatismos pueden hacer que un sujeto normal caiga permanentemente en una definición de anormalidad. Por otro lado los procesos críticos de personalidad en los cambios hormonales o afectivos pueden poner a los sujetos normales en definición de anormalidad no permantente.
El caso de algunas enfermedades mentales de origen neuropatico tenen una evolución previsible (al menos teóricamente), que suelen poner en el carácter de anormal al paciente.

Raul Espejo Rodarte

I am so sorried I was thinking in spanish:

2.3.9.1 Special teaching.
When the student present atipical behavior afects the teacher who is unprepared and has not time.
It is a situation in two ways, one of the students who lack the faculties required for their professional development, or for those students who definitely have a much higher capacity, for which normal studies seem dull and slow. Both cases are a problem for the teacher "normal" and to those found in the case of superiridad frankly forcing them to waste their talents to an average performance (normal). In most unfavorable cases, the subject shows a great improvement when treated like a "normal" person.
2.3.9.2 Abnormal behavior
Normal probability distribution raises the explanation. If, for example, we limit to the intelligence quotient (IQ) for adults, is supposed to have a normal distribution with mean 100 and standard deviation of 15 (or so), more than 95% of the population is in the range 70 at 130, so that interval below or above it, the subject is considered "abnormal". Suggesting that 5% of the population is abnormal. Fortunately at the higher levels of education students have been selected by admission tests and natural selection in previous educational stages.
Cases of drug abuse or trauma can cause a normal person falls permanently in a definition of abnormality. On the other hand the critical processes of personality or emotional hormonal changes may make the normal subjects in temporal definition of abnormality.
For some mental illnesses of neuropathic origin holdings predictable evolution (at least theoretically), which usually put in the abnormal character of the patient.

Mish

A man wearing a dress may also be transgendered! If he is, his brain is telling him he is the opposite gender and he's responding to that.

Cause? Thought to be due to hormone flooding, possibly mother reacting to stress, while the baby is in utero.

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