Definitions of abnormality: deviation from ideal mental health
The deviation from ideal mental health definition of abnormality concentrates on identifying the characteristics and abilities people should possess in order to be considered normal. A lack of or impoverishment of these characteristics and abilities constitutes a diagnosis of abnormality. The definition therefore has a perception of mental disorder as being similar to that of physical health, in that an absence of wellbeing means that an individual is ill. Jahoda (1958) devised the concept of ideal mental health and identified set characteristics that individuals need to exhibit to be seen as normal. The more of these criteria an individual fails to realise, and the further away they are from meeting individual criteria, then the more abnormal they are considered to be. Similar to the deviation from social norms definition and the failure to function adequately definition, the deviation from ideal mental health definition also concentrates on behaviours and characteristics that are seen as desirable, rather than undesirable.
There are 6 characteristics of ideal mental health:
1 Positive attitude towards oneself, which involves having self-respect and a positive self-concept where individuals regard themselves favourably
2 Self-actualisation, where individuals should experience personal growth and development. Self-actualisation involves ’becoming everything one is capable of becoming’
3 Autonomy, which concerns individuals being independent, self-reliant and able to make personal decisions
4 Resistance to stress, where individuals should be in possession of effective coping strategies in response to stress and should be able to cope with everyday anxiety-provoking situations
5 Accurate perception of reality, where individuals should be able to perceive the world in a non-distorted manner and possess an objective and realistic perception of the world
6 Environmental mastery, which concerns individuals being skilled in all aspects of their lives, both socially and occupationally and being able to meet the requirements of all situations they experience. Additionally, individuals should possess the flexibility to be able to adapt to changing life circumstances, both socially and occupationally.
As the definition gives identification to specific types of dysfunction, it permits targeting of exact areas for mental health practitioners to work on when treating a person’s abnormal condition. This can prove beneficial when treating different types of disorders — for example, focusing on the specific problem areas of a person with depression.
A positive aspect to this definition is that it stresses positive accomplishments, rather than failures and distress, and therefore promotes a positive approach to mental disorders by focusing on what qualities are appropriate, rather than which ones are inappropriate.
The definition can be seen to take a holistic approach, one that is interested in developing the whole person, rather than a reductionist approach that just focuses on individual areas of a person’s behaviour.
A positive aspect of the definition is that, as it identifies areas where personal weaknesses exist, it can be seen to be promoting self-growth by giving opportunities to improve on these areas.
According to these criteria, most — if not all — people would be abnormal most of the time. Therefore, the criteria are over-demanding. For example, few people experience continual personal growth, indeed the opposite may be periodically common. Self-actualisation is seen as something that very few people achieve, so does this mean the majority of us are abnormal? The criteria may actually be ideals of mental health: how we would like to be, rather than how we actually are.
The characteristics used to assess mental health are culturally relative and should not be used to judge people from other cultures and sub-cultures. For instance, some mental disorders only exist in certain cultures, such as Koro, found only in south-east Asia, China and Africa, which is a disorder concerning the belief that a man’s penis is fatally retracting into his body. Therefore, Western cultural views of abnormality, like the deviation from ideal mental health definition, are not culture-free.
Many of the criteria are subjective, being vague in description and rather hard to measure in any objective way. Measuring physical indicators of health is generally easy, for example by using blood tests and scans, but diagnosis of mental health is much trickier and relies largely upon the self-reports of patients, which may not be reliable if they have a mental disorder.
A practical application of the definition is that it permits identification of what is needed specifically to achieve normality. This therefore allows mental health practitioners to create personal targets for patients to work towards so that they can achieve better mental health.
Fig 4.2 The deviation from ideal mental health definition may be more about the ideal self than the actual self