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.
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"?