Thursday, May 8, 2008

NORMALITY and ABNORMALITY

Perceptions of Normality and Abnormality differ between cultures, subcultures, individuals and change over time. The extreme selfishness of a child is accepted as normal; in an adult such selfishness would be regarded as abnormal. Men holding hands is normal in some societies, in others it is regarded as abnormal.

For a person to be quiet and withdrawn may be normal for THAT individual. For a person to be noisy and active may be normal for THAT individual. If the individual's behavior CHANGES then, FOR THAT PERSON, the behavior may be abnormal. Therefore, we have to take account of all the factors relating to an individual before LABELLING their behavior abnormal.

It is important for treatment and research that health professionals use the same language when describing a disorder. In these sessions a classification system will be introduced for use in the rest of the course.

NORMALITY

As we have seen, normality means different things to different people at different times in different settings. If, as a soldier, we shoot someone in wartime we may receive a medal; if we shoot someone in peacetime we will be put in prison. If we lose our job and someone close to us dies then it is normal for us to be unhappy and depressed. In fact if we were not unhappy and depressed it would be abnormal. Therefore we have to look at emotions and behavior in the context in which they occur.

THE FOLLOWING IS ONE SUGGESTION OF THE CHARACTERISTICS OF A NORMAL MENTALITY, PERSON

1. EFFICIENT PERCEPTION OF REALITY
They have a realistic view of their strengths and weaknesses. They know what they have the ability to do and what they cannot do. They have a realistic Perception of what is happening around them and their reactions to those events.

2. SELF KNOWLEDGE
They have an understanding of WHY they do things [MOTIVATION] and WHY they have certain emotions. None of us has complete Insight into our feelings and behavior but normal people have more Insight than the mentally ill.

3. ABILITY TO CONTROL BEHA VIOUR
Occasionally normal people may act impulsively [Without thinking] but normally they can control DRIVES such as aggression or sexuality.

4. SELF-ESTEEM
They know their own value and feel happy with their achievements and abilities. They feel accepted by those around them. They may wish that they were more handsome or intelligent but they don't allow these ideas to rule their lives. They know that though they may not be handsome they have a nice personality or, that though they cannot be a university professor they are doing a useful job which brings in money for the family to live on. 
Mentally disordered people often feel that they are worthless and not accepted by other people. They may blame society or other people for their feelings of worthlessness and Rejection.

5. ABLE TO FORM CLOSE RELA TIONSHIPS
NORMAL people are able to form close and satisfying friendships and relationships. They are aware of other peoples feelings and beliefs and adapt to them.
Mentally disordered people often think only of their own problems and are unable to care about other peoples problems [they are often Self-centered]. Sometimes they do not want to form close friendships because at some time in the past they were emotionally hurt by the breakup of a relationship.

PRODUCTIVITY
They are able to channel their energies into work' and social life. They are enthusiastic about their lives and enjoy activities.
Mentally disordered people often feel chronically tired and each day is an obstacle to be suffered, not enjoyed.

ABNORMALITY
DEFINING ABNORMALITY IS AS DIFICULT AS DEFINING NORMALITY. THE FOLLOWING ARE THE CRITERIA OFTEN USED IN DEFINING ABNORMALITY

1. DEVIATION FROM SOCIAL NORMS
Every society has certain standards [or Norms] of behavior that it expects. Such things as the way we dress, politeness, bad language are subject to certain rules [often unwritten]. However, Social Norms are different in different societies. Eating in public during the day at Ramadan would be regarded as a deviation in the Emirates and would be punished. It would not be a deviation in a non-Islamic country.
Eye contact between a superior and inferior is regarded as a deviation in some parts of the Sub-Continent. A student who looked his teacher in the eye would be regarded as rude and arrogant. This has created problems for individuals from some parts of the Subcontinent when taking examinations in the United Kingdom. Where avoiding eye contact is regarded as a sign that the person is guilty and has something to hide.
Ideas of what is normal and abnormal also change over time. At one time, in the history of England, it was normal for men to wear earrings. When the author of this unit was a boy a man wearing an earring would be regarded as a homosexual and probably attacked if he wore earrings in the street. Now many young heterosexual men wear earrings and it is accepted behavior.

2. MALADAPTIVE BEHA VIOUR
Behavior is abnormal if it is Maladaptive ie: it has an adverse [bad] effect on the well-being of the individual or society. For example a person who is so frightened of crowds that he cannot leave his home or a person who drinks so much alcohol that he cannot live a normal life. Individuals who are violent and aggressive have a bad effect on society. They may release their aggression on the roads and cause traffic accidents or indulge in crime.

3. PERSONAL DISTRESS
In this criteria one would look at the person's subjective [internal] feelings rather than their [external] behavior. They may feel unhappy, depressed and agitated. They may be unable to concentrate or sleep. They may hide these feelings from others and their behavior may appear normal. There may be the "Smiling Depression" where an individual is very depressed but hides that depression from family and friends. Often the first that his family know of the depression is when he attempts to kill himself. 

KEY POINTS:
1. Mental Disorder has Physical, Psychological and Social Dimensions.
2. Judgments of psychological and social functioning have reference to social and cultural norms.
3. Many mental disorders are not Illness but are responses to problems in living. Labeling may prejudice our judgment as professionals.

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