NORMALITY VS

ABNORMALITY

Col. Khalid Hayat Khan

Classified Psychiatrist

MH Rawalpindi

Normality

• The World Health Organization (WHO) considers normality to be a state of complete physical, mental, and social well-being.

• Normality has been defined by psychologists as patterns of behavior or personality traits that are typical or that conform to some standard of proper and acceptable ways of behaving.

(Kaplan and Sadock’s Synopsis of Psychiatry 10th edition)

• The use of terms such as typical or acceptable, however,

has been criticized because they are ambiguous, involve

value judgments, and vary from one culture to another.

To overcome this objection, a psychiatrist and historian

George Mora devised a system (Table 1) to describe

behavioral manifestations that are normal in one context

but not in another, depending on how the person is

viewed by the society.

Normality in Context

(Table 1, data from George Mora)

TERM CONCEPT

Autonormal Person seen as normal by his or her own society.

Autopathological Person seen as abnormal by his or her own society.

Heteronormal Person seen as normal by members of another society observing him or her.

Heteropathological Person seen as unusual or pathological by members of another society observing him or her.

Functional Perspectives of Normality

The four functional perspectives of normality as described by Daniel Offer and Melvin Sabshin are:

Normality as Health

Normality as Utopia

Normality as Average

Normality as Process

Normality as Health

Most physicians equate normality with health and view

health as an almost universal phenomenon. As a result,

behavior is assumed to be within normal limits when

there is absence of signs and symptoms or no

psychopathology is present.

Normality as Utopia

• The perspective views normality as the harmonious and optimal blending of the diverse elements of the mental apparatus that results in optimal functioning.

• An ideal man with no mental conflicts and a balanced Id, Ego and Super ego.

• This approach about normality is characteristic of psychiatrists, psychologists and psychoanalysts.

Normality as Average

• This perspective is based on a mathematical principle of the bell-shaped curve. This approach considers the middle range normal and both extremes deviant.

Deviant Deviant

Normal

• This approach is more commonly used by psychologists

(psychometric tests, psychiatric rating scales) than

psychiatrists.

Normality as Process

• Normal behavior is the end result of interacting systems.

• This approach is most commonly used by behavioural and social psychologists.

• A typical example of the concepts in this perspective is Erik Erikson's conceptualization of personality development and the seven developmental stages essential in the attainment of mature adult functioning.

Criteria for Abnormal Behaviour

• Deviance

• Maladaptive behaviour

• Personal distress

Deviance

• People are often said to have a disorder because their behavior deviates from what their society considers acceptable. For e.g.

• Bike wheeling

• Sexual perversions

Maladaptive Behaviour

• People are judged to have a psychological disorder because their everyday adaptive behavior is impaired.

• Substance use (alcohol, cannabis, heroin etc)

• Violence

• Suicide and Deliberate self harm (DSH)

Personal Distress

• The diagnosis of a psychological disorder is based on an individual’s report of great personal distress.

• Depressed people

• Anxious people

Who is Normal and Healthy?

Following are the parameters which describe the state of psychosocial health and normalcy.

Dynamism

Optimization

Personal contentment

Socially responsible

Occupationally effective

Economically emancipated

Freedom from pain and discomfort

Homeostasis

Dynamism

• This term refers to the different roles and functions of the human being and their changing and evolving nature.

• In his lifetime a person performs various roles and contributes to the growth of his own self, to the society and the world at large. In one role he is a student, in another he is a brother, a teacher, a scientist, a bread earner and a sportsman. The more roles he performs the more dynamic he is.

• Illness and disability limits the diversity and dynamism of a human being.

Optimization

• When a person performs most of his roles in an optimum

state, he is considered psychosocially healthy. While it

may not be possible to stay at your best all the time; a

normal and a healthy person views himself as being in a

state of productivity in most of the dimensions and roles.

Personal contentment

• Despite failures and difficulties and inability to be the

world’s best scientist or best player or best father, a

normal person accepts his capabilities and shortcomings

and focuses on the positives and his achievements of life

in order to attain a sustained state of satisfaction and

ease.

Socially Responsible

• A healthy person takes responsibilities of the roles and

duties assigned by the society, starting from his

immediate family to his neighbourhood and town, and

country and to the world at large. He pursues the theme

of making this world a better place for him and for the

subsequent generations.

Occupationally Effective

• Whatever be his means of livelihood, he is effective

occupationally in terms of skills, knowledge and wisdom.

He is also helpful to the society through his occupation

and attempts to pass his skill, knowledge and wisdom to

others.

Economically Emancipated

• Whatever be his occupation or means of earning, he

should have a sense of being liberated from the

pressures of economics, in a way that it does not inhibit

his goals or objectives of life.

Freedom from pain and discomfort

• His dealings and relationships is such that he is devoid

of distress, discomfort and pain both at the physical as

well as at a psychological level of mistrust, deceit,

jealousy, prejudice, intolerance and ignorance.

Homeostasis

• When a person works and interacts with other human

beings and his environment, he pays respect to the

rights of others and gives due importance to the laws of

nature; he is said to maintain a homeostasis with his

environment. He does not threaten the environment,

neither does he feel threatened by it; instead he makes

an earnest effort to improve it. He therefore feels in

harmony with his internal and external environment.

THANK YOU