abnormality

Throughout the history of man, there have always been individuals behaving against the current by acting or believing in so-called strange and outlandish ways. Some may view this as eccentricity or down right bizarre. Others may perceive this as signs of illness or distress and characterize the individual as mad or insane. This behaviour in lay terms could be understood as abnormal. However, this term is rather superficial as one begins to examine what really makes someone abnormal in relation to what is considered normal or acceptable. This paper examines the varying ways in which abnormal behaviour may be approached and perceived by tracing the history of major psychological theories and paradigms. Finally abnormality is considered in its relation to the idea of normality. It is concluded here that no coverall definition is available to account for the rationale behind what constitutes as abnormal behaviour. Instead it is believed that abnormality is a misleading notion based on natural human tendencies of categorization and comparison.

Progressing views of abnormal behaviour
The concept of ‘abnormal behaviour’ is rather equivocal and proves exceptionally problematic in establishing a standard criterion in which to examine. This difficulty is embedded within the historical context of society which ultimately varies, from one society or culture to the next. Moreover even within a society, values and beliefs change over time which in turn affects the way in which a phenomenon is interpreted and observed. This is illustrated in the Middle Ages where religion dominated every aspect of society, abnormal behaviour witnessed in individuals was interpreted as possessions from demonic or evil spirits. Subsequently, as secularism gained power and authority towards the end of the Middle Ages, views of abnormality shifted from the supernatural to biological. Abnormal behaviour, in turn became defined as a mental illness analogous to physical ailments which one either had or did not and thus was treatable like an illness within a mental hospital or asylum. By the beginning of the 20th century this bio-medical model of abnormality split into two distinct theoretical and clinical models: somatogenic and psychogenic (Bennett 2006).

The somatogenic model of abnormality assumes that defective brain chemistry results in abnormal behaviour. Individuals displaying abnormal behaviour are referred to as ‘patients’ and are subsequently treated in a hospital setting to alleviate the chemical imbalance. Historically, these ideas can be traced back to Hippocrates (4 BC) who believed that such disturbing behaviour resulted from a disproportion in the four central bodily fluids: blood, black bile, yellow bile and phlegm. As a result, a strict diet and routine were implemented to restore the levels of fluids (Stone 1937; Davies & Bhugra 2004; Bennett 2006). During the First and Second World Wars the bio-medical model was the primary approach utilized in treating mental illness with therapies such as the insulin coma therapy (ICT), prefrontal lobotomy and electroconvulsive shock therapy (ECT) being employed (Davies & Bhugra 2004). In recent times, pharmaceutical drugs have become increasingly prescribed treatments for mentally ill patients. Modern drug therapies are intended to regulate neurotransmitter activity in the brain which is viewed as the root cause of mental illness.

The second theoretical branch of the bio-medical model is less biological in its approach than its counterpart. The psychogenic view of abnormality attributes ill mental health to the internal psychological processes of individual rather than assuming defective biological properties. Again, individuals are ‘patients’ perceived as suffering from ‘symptoms’ specific to an ‘illness’. The psychogenic model emphasises importance on pinpointing the root cause of the illness and how it may have developed. This approach is much more interpretive and focuses on examining a patient’s history. Psychoanalysis is the dominant approach within this model. Psychoanalysts believe that psychological illnesses in adulthood are the product of unpleasant childhood experiences (Muris 2006). Thus one must gain an understanding of the cause of the patient’s illness in order to treat it. Sigmund Freud’s psychoanalytic approach emphasised that unconscious sexual motivations towards their parents within childhood are repressed in order to fit in with societal norms. Subsequently this repressed energy manifests itself as abnormal behaviour in adulthood. To Freud, patterns within abnormality must be deciphered in order to understand the meaning of the illness (Davies & Bhugra 2004). Since Freud there have been many subsequent psychoanalytic offshoots, all of which highlighting the importance of early childhood development and relationships particularly with the mother.

By the middle of the twentieth century perceptions of abnormal behaviour as an illness began to wane, and soon patients were released from mental institutions and back into the community, this was due to developments of other theoretical models of psychopathology within psychology. The behaviourists emerged as proponents of the scientific study of behaviour greatly opposed to Freudian psychoanalytical theory which was unable to prove falsifiable. Human behaviour is perceived to be completely learned by interactions and associations within the environment. Behaviourism states that learning is the result of stimulus-response relationships (Bennett 2006). Thus abnormal behaviour is viewed as a consequence of maladaptive learning. Only observable behaviour is of interest since it is viewed as objective in contrast to internal thoughts and beliefs which are considered subjective, threatening the reliability of the science. Consequently, if unacceptable behaviours can be learned they are also able to be unlearned and subsequently replaced with more normative conduct.

Behaviourism began to decline by the 1970s being replaced by cognitive approaches to abnormal behaviour. Early on the behaviourists had discounted internal processes as a vital entity in shaping behaviour labelling it the ‘black box’. This was later taken up by the cognitive therapists who believe that cognition, thinking, perception and reasoning are the precursors of all behaviour normal and abnormal. Similar to the behaviourists, cognitive therapists recognize abnormal thought patterns as products of maladaptive learning. Cognitive therapists work with ‘clients’ aiding them to pinpoint abnormal thoughts and perceptions in order to turn them into more acceptable ways of thinking. However both behavioural and cognitive therapists’ stance towards abnormal behaviour heavily conforms to societal and cultural norms (Davies & Bhugra 2004) particularly evidenced in views towards sexuality. During the height of behaviourism, proponents attempted to eradicate homosexuality among males, as a result electroshock aversion therapy was implemented to straighten (pun intended) them out. This behaviour at the time was rather unacceptable to the majority of society particularly those in power. Davies & Bhugra (2004) adequately summarize this idea stating,

Those who have more power tend to define “reality”… Further, behaviour viewed as unacceptable or desirable by one person or group may not be so by others… [Subsequently] unwanted behaviour is not self-evident but is socially negotiated (pp.80).

The 1960s saw a great shift in society with values and norms constantly under scrutiny and re-evaluation. As a result psychologists soon began to re-examine their views of abnormality taking into account societal influences and even at times drawing upon relevant sociological theories. It has been evidenced that psychopathology is linked to social class, high levels of stress, and poverty (Davies & Bhugra 2004; Bennett 2006). Negative views towards women and ethnic minority groups are likely to yield increased stress and consequently mental problems. Therefore it is valid to examine abnormality as a result of social setbacks and exclusion.

Finally, the humanistic model of abnormal behaviour is addressed, as it developed in opposition to the psychoanalytic and behaviourist approaches. Carl Rogers, the founding father of this paradigm, believed that no objective reality exists outside an individual, rather a subjective reality specific to each and everyone. Second all individuals possess ‘free will’ whereby people are not dictated by the past nor present conditions (Bennett 2006). Lastly, Rogers claims that the desire to develop and improve oneself is an innate human quality. Thus from the humanistic perspective, psychopathology is the result of an incongruence between the actual and ideal self (Davies & Bhugra 2004). As a result, abnormal behaviour is only abnormal in respect to the individual’s perceived notion of normality. However, the idea that all humans desire self-improvement is ambiguous and value-ridden. Subsequently this idea can lead to issues where one’s concept of normality impinges on or conflicts with another’s, in which case it would appear that we live in a society ridden with self-centredness and contradiction. Although this is true on some levels, on the whole society is rather harmonious as a result of a shared understanding of what is constituted as ‘normal’ and ‘abnormal’ behaviour.

How can we define abnormality?
In its most literal sense abnormal behaviour can be defined as that which diverges from ‘normal’ behaviour which is not out of the ordinary and conforms to social rules and values. This superficial explanation roughly conveys what most lay people may judge as abnormal. For example if someone suddenly began screaming absurdities in a busy street, people would begin to interpret this eccentric behaviour as symptoms of being a drug-addict, a schizophrenic or insane. Subsequently, all further actions by this person will be attributed as further signs of their illnesses. This is the basic theory asserted by label-theorists, whereby labelling someone creates a role in which assumptions are made and sometimes this individual may even begin to fulfil these expectations unintentionally (Davies & Bhugra 2004). A well-known study by Rosenhan (1972) revealed this occurrence. Eight ‘sane’ students were sent to their local psychiatrists and only instructed to reveal that they heard voices in their heads. All eight students were subsequently checked into psychiatric wards diagnosed as schizophrenics. Once inside, the psychiatrists observed all of their mundane behaviour recording it as unusual and pathological. Szasz (1974; 22) eloquently states that ‘he who first seizes the word imposes reality on the other’. A major problem surrounding this issue is the idea of a dualistic nature between normality and abnormality, that either an individual is normal or abnormal. This is a good example of heuristics in human nature when behaviour is not ordinary it is automatically assumed that there is something wrong. It is also important to note that abnormality cannot exist without normality, something to compare it against. Thus we return to the concept of normality. One can judge this statistically as that which falls within the bell curve of general populations’ average, with abnormality falling on either extreme side (Gallagher 1955; Davies & Bhugra 2004). This psychometric approach proves futile when one examines the validity of a test which dictates such results. A common test used to judge intelligence (the standard IQ test) is rather controversial as an accurate measure of intelligence. Many argue the test is culturally biased and that it only assesses a narrow scope of intelligence. How then can we measure normality objectively? Normality itself is a fallacy which in turn proves impossible to define abnormality making it just as absurd a notion.

In conclusion, abnormal behaviour is only an abstract concept and does not exist objectively in the world, nor does it exist as a property within human beings. Abnormality represents a deviation from the ideal type proposed by our socio-cultural expectations of normality. This is clearly illustrated in the historical development of views of abnormality. Further, heuristics play an important role in this by categorizing and comparing individuals, we eventually begin to pigeon-hole fellow beings as mentally stable or ill. In the grand scheme of things this critical assessment of others’ behaviour treads into moral territories as to what is right and wrong or good and bad behaviour. Such a progression in this direction really begins to take the nature out of human nature.

References

Bennett, P. (2006) Abnormal and Clinical Psychology. 2nd Edition. Maidenhead: Open University Press in association with McGraw-Hill Education.

Davies, D. & Bhugra, D. (2004) Models of Psychopathology. Maidenhead: Open University Press in association with McGraw-Hill Education.

Gallagher, J. (1955) Normality and Projective Techniques. Journal of Abnormal and Social Psychology. 50(2), pp.259-264

Muris, P. (2006) Freud was Right… About the Origins of Abnormal Behaviour. Journal of Child and Family Studies. 15(1), pp.1-12.

Stone, S. (1937) Psychiatry Through the Ages. The Journal of Abnormal and Social Psychology. 32(2), pp.131-160.

Szasz, T. S. (1974) The Second Sin. New York: Routledge.