Psychology 101: The 101 Ideas, Concepts and Theories that Have Shaped Our World - Adrian Furnham 2021

Normality and Sanity

Insanity left him when he needed it most. (Roger McGough, Tramp, Tramp, Tramp, 1986)

Clinical psychologists study what they call abnormal behaviours. They look at the origins, manifestations and treatments of disordered habits, thoughts or drives. Inevitably these abnormalities cause stress. These may be caused by environmental, cognitive, genetic or neurological factors.

For clinical psychology, the issue is not so much whether the behaviour is abnormal, as whether it is maladaptive and causing a person distress and social impairment. If a person’s behaviour seems irrational or potentially harmful to themselves and others we tend to think of that as abnormal. For the psychologist it is called psychopathology, for the layperson, madness or insanity.

While it is relatively easy to spot people who are distressed or acting bizarrely it is much more difficult to define abnormality.

NORMALITY VS ABNORMALITY: Five Different Ways of Looking at this problem

Subjective: This is the idea that uses our behaviour and our values as the criteria of normality.

So people like us are normal, those different are not. This approach also tends to think in simple categories or non-overlapping types: normal — abnormal — very abnormal.

Normative: This is the idea that there is an ideal, desirable, state of how one should think and behave. Normality is perfection: the further from normality one is the more abnormal. It’s a more ’what ought to be’ than ’what is reasonably possible’ state of affairs.

Cultural: Culture dictates trends in everything from dress to demeanour. Certain things are taboo, others are illegal. Again, the further away or different from culture norms a person appears to be, the more he or she is judged as abnormal. However, as culture beliefs and practices change so do definitions of normality.

Statistical: All statisticians know the concept of the bell curve or the normal distribution. It has particular properties and is best known in the world of intelligence. This model has drawbacks in the fact that behaviour that occurs frequently does not necessarily make it healthy or desirable. Also, while it may work for abilities which are reasonably straightforward to measure, it is less easy with more subtle and multi-dimensional issues like personality or mental illness.

Clinical: Social science and medical clinicians attempt to assess the effectiveness, organization and adaptiveness of a person’s functioning. Much depends on which dimensions are being assessed. Clinicians also accept that the normal—abnormal distinctions are grey and somewhat subjective, though they strive for reliable diagnosis. Abnormality is usually associated with poor adaptations, pain or bizarre behaviours.

GENERALLY AGREED UPON CRITERIA

Psychological definitions of abnormality revolve around half a dozen or so ’generally agreed upon’ criteria. These have been called the 4Ds: distress, deviance, dysfunction and danger. Abnormality generally involves pain and suffering. Acute and chronic personal suffering is one criteria. Another is poor adaptation — not being able to do the everyday things of life, such as hold down a job, maintain happy interpersonal relationships and plan for the future.

A very common criteria is irrationality — the person has bizarre, illogical beliefs about the physical or social world as well as very often, the spiritual world. Their behaviour is often incomprehensible to others. Abnormal people are often unpredictable; they can be very volatile, changing from one extreme to another and often quite unable to control their behaviour. Their behaviour is often very inappropriate.

Almost by definition their abnormality is characterized by unconventional, rare and undesirable behaviours. It is sometimes called vivid and eccentric. In addition, abnormality has a moral dimension. It is associated with breaking rules, violating moral standards, disregarding social norms. Illegal, immoral, undesirable behaviour is abnormal.

There is one other rather interesting criteria of abnormality. It’s the discomfort that is generated in people around abnormality. Observers, be they friends, family or just onlookers often feel uncomfortable around clear evidence of abnormality.

The problems with any definition of abnormality are clear.

First a healthy person in an unhealthy society is often labelled as abnormal. There have been many historical incidents where sick societies have been deeply intolerant of those who don’t obey or concur with their narrow (unhealthy, maladaptive) standards of belief and behaviour.

Second of course, expert observers can’t agree on the categorization of normal vs. abnormal. Even when multiple criteria of abnormality are specified, there remains fundamental disagreement about whether a person is considered in some sense abnormal.

Third, there is the actor—observer difference: who is to make the judgement? ’Actors’ rarely think themselves abnormal: most of us are reasonably positive about ourselves and indeed have a great deal of information others do not have. Yet there are well-known traps and hazards in making a self-diagnosis. It is easier to be observers and label others abnormal, particularly those different from us or threatening to us.

Fifty years ago Marie Jahoda proposed a simple but effective checklist to understand what ideal, mental health is. The six points are:

1 A positive attitude to the self: positive but realistic self-esteem. We need to feel (appropriately) good about ourselves. Having a strong sense of identity.

2 Self-actualization: the idea is that of contentment, achieving your goals and exploring your talents. Having an ability to self-regulate.

3 Autonomy: having a sense of independence and self-reliance. To function alone and not being dependent on others. Being well integrated with other people.

4 Resistance to stress: not feeling in a constant stage of stress, or that one has not got good coping strategies to deal with it. Having a sense of personal growth.

5 Environmental mastery: a sense that one can adapt easily to new situations and life circumstances and be successful and well-adapted.

6 Accurate perception of reality: having a worldview similar to that of others. Not having distorted views.

REFERENCES

Furnham, A. (2015). Psychology: 50 ideas you really need to know. London: Quercus.

Jahoda, M. (1958). Current concepts of positive mental health. London: Penguin.