UNUSUALNESS
One trait or standard commonly used since the early days of psychology to diagnose certain behaviors as abnormal would be their level of “unusualness”. Those behaviors that deviate from what is usually considered normal tend to be categorized as unusual or abnormal, while those behaviors that fall within the scope of what is considered typical is considered normal, or “the usual”. This mode of categorization tends to fall within the scope of relativist modes of categorization, as they can directly correlate with the cultural norms that are used as a standard of comparison for what is considered to be normal behavior. To put this into perspective, how unusual would you, the reader, consider it to be for a bereaved family member to hysterically cry and scream in a public setting? The answer to this question highly depends on whether you happen to find yourself in Indianapolis or Beirut.
Using “unusualness” as a standard of comparison additionally presents other issues. For example, how does one measure a behavior’s level of abnormality? Should we say that behaviors exhibited by 10 percent of the population be considered abnormal, or set the bar higher for less than 1 percent of the population? A caricature of this conundrum would be two witches having a conversation and asking each other whether people hate them because they dress like witches, or they dress like witches because people hate them? As far as choosing a cutoff in relations to certain behaviors exhibited by a percentage of the population, and what percentage that should be as encompassing a greater or smaller number of behaviors, is as subjective and biased to determining abnormality as relying on the personal opinion of somebody to consider what is abnormal.
Another problem that arises out of giving a certain behavior the “unusual” label in order to determine whether it should be labeled as abnormal is the fact that many people who possess rare abilities or exhibit rare behaviors can be deemed to be beneficial both to the individual as well as to society as a whole. An expert piano player is seen as gifted instead of exhibiting some form of abnormality. Some people dabble in strange or uncommon activities and hobbies, that are fascinating to them but do not cause harm to themselves or other people.
These people can sometimes be called “eccentrics”. A good example to cite in this regard is that of Gary Holloway, an environmental planner employed by the city of San Francisco. This following case study describes his situation:
“A subject of Gary’s fascination is that of Martin Van Buren, the 8th president of the United States of America. Some two decades ago he found out that Van Buren was the only president to not have a society dedicated to him, so he established the Martin Van Buren Fan Club. Holloway proudly explained that ‘This man did absolutely nothing to further our national destiny, but despite this, I’ve managed to get hundreds of people following me in commemorating him.’ Holloway has been the president of the club for 18 consecutive terms, and has also won the Marty award for 18 consecutive years, an award giving it’s holder the prestigious title of excellence in Van Burenism. Aside from this, Gary is also greatly devoted to St. Francis of Assisi, and often wears the outfit of a Franciscan monk. Gary says ‘It’s fun to wear, comfortable and I like the response I receive when I wear it. People always offer me a seat on the bus.’ Gary also has an obsession with the British Commonwealth and possesses encyclopedic knowledge of such locales as Tristan da Cunha as well as Fiji. During the Falklands War he was in strong support of the British islanders whom inhabited the Falklands, going so far as to display the Falklands flag on the front lawn of his house. After the war he continued to celebrate the British victory in the Falklands, even by renaming his house to Falklands House and resuming to fly the flag on his lawn. His bedroom inside his Falklands House still retains much of his possessions that he has had since he was a child. He refers to his bedroom as the ‘Peanuts Room’ due to his large collection of Snoopies and other peanut related memorabilia. He has also slept on the same twin sized bed for 40 years, since he was a small child. He has dozens of toy airplanes in addition to his wall being covered in pennants. He continued to point out, humoristically ‘As a monk, I’m always doing pennants”. Many eccentrics are known for their sly sense of humor.”
Despite the eccentricity of Gary Holloway’s hobbies, would they be considered abnormal?
DISTRESS
For distress to be considered a criteria for abnormality, the patient must consider his symptoms to be causing him distress in a way that is negative, that he or she recognizes as distress and therefore wants to eliminate these symptoms and therefore the distress. The advantage to using this criterion to assess abnormality is that it avoids incorporating cultural norms when assessing for abnormal behavior. According to this criterion, a simplistic approach to assessing abnormality would be if the behavior described does not cause a person distress, yet goes against societal norms, it should not be considered abnormal.
There are many medical professionals who do not agree with this wholeheartedly, as many people who exhibit various types of behavior that they do not consider to cause distress to them can potentially be harmful to others. There are those who show symptoms of mental disorders such as psychosis, among others, in which the patient has either lost touch with reality or it has become distorted to them. Many would wander the streets without purpose, sometimes talking to themselves, ignoring basic needs such as sleep or hunger, which creates a danger for sleep deprivation, starvation and potentially getting sick from adverse weather.
People who exhibit these signs might not be conscious of their problems, and subsequently fail to ask for assistance in curing or treating their ailment. The issue raised here is that people who do not possess awareness as to their ailments would not seek help, so clinical intervention is recommended as those who are unaware and voluntarily do not seek help would not see the benefits of available treatment options.
There is also the argument that even though distress might not be caused to oneself, the person exhibiting certain behaviors might cause distress to others. A very simple example to illustrate this conundrum is those who engage in acts of lying, cheating, stealing and violence towards others – while it may not cause distress towards themselves it certainly does towards other people. They may not only not feel suffering as a result of their actions, but it would cause them great pleasure to commit these acts. As a result of this it is wise to consider these behaviors abnormal despite the fact that it does not cause distress for the people exhibiting them.
MENTAL ILLNESS
There are those who insist that behaviors should not be considered abnormal unless they fell within the scope of mental illness. This type of thinking would assume that some sort of process that is causing a disease, such as diabetes or hypertension, is allowing for this behavior to come to fruition. The assumption here takes the notion of a person showing symptoms of schizophrenia to have this disease show up on a blood test or another type of biologically based medical assessment, similarly to how hypertension can be revealed once a person’s blood pressure is taken.
Despite this, there is no known biological test available to assess any psychological abnormalities that are often common among the general population. This could possibly be due to the fact that many of the biological tests needed to adequately assess the existence of a mental illness in a patient simply do not yet exist as of publishing of this article. There are those who insist that mental illnesses are composed of a number of both biological and psycho-social factors, that make it next to impossible to get a definitive diagnosis when it comes to pinpointing exactly which mental disorder the patient is suffering from. In some cultures mental illnesses are also referred to “diseases of the soul”.
When a person’s symptoms are diagnosed to be a certain mental illness, they are more accurate depictions of the symptoms instead of being a sure cut label when it pertains to the mental illness itself. When we diagnose a person with obsessive-compulsive disorder, for example, we are actually referring to the set of symptoms that are observed through the exhibition of obsessive thoughts and compulsive behaviors in that individual. Therefore, the term “obsessive-compulsive disorder” is not indicative of the same physical process across all people exhibiting these types of symptoms and this type of behavior that we are capable of identifying through the use of biologically based medical assessments as when doing similar types of biologically based medical tests when attempting to identify cancer, for example.
ABNORMALITY DEFINED BY FOUR WORDS STARTING WITH THE LETTER D
In modern times, abnormality in the psychological sense is not something defined by the previous criteria but rather by the dynamics presented through the assessment of four dimensions – dysfunction, distress, deviance and dangerousness.
Emotions and actions are deemed to be dysfunctional when a person is not able to perform a job, form relationships or do any other activity that most people would consider to be a basic daily routine. The greater the level of dysfunction, the more plausible they are to be evaluated as abnormal by mental health service providers.
Abnormal behaviors are also assessed in terms of the level of distress they are able to cause to both the person exhibiting them as well as to the people around him that are observing these behaviors. Abnormality is also assessed through deviant behaviors, those including hearing voices when no one is around and constant lying and kleptomania.
The fourth definition vector, dangerousness, includes behaviors that denote the possibility of the individual to commit suicide or self harm, or rampant aggression towards others such as violent and homicidal tendencies. The combination of these definitive vectors together contribute to an observational and empirical assessment that results with the patient being evaluated as “abnormal”.
To reiterate: Any actions or emotions that are have the potential to inflict physical harm to oneself or to others, are unusual both in a cultural and human sense, impede on a person’s ability to perform daily tasks and causes them to suffer needlessly, are deemed to be abnormal.
The four words starting with the letter D provide a better, more accurate and impartial picture of abnormality as criteria for assessment such as cultural relativism, unusualness, distress and illness. Results from assessments will nevertheless end up being subjective.
Things like the level of emotional pain and suffering a person must be going through due to their mental illness, and the disruption of day to day functioning must be determined with the wisdom, knowledge and experience of the evaluator. What is the extent to the interruption of day to day functioning in order for the behavior to be classified as abnormal? What about it’s nature? The continuum model is helpful for visualizing the four words starting with the letter D and how they fall into place in defining abnormality. There are extents to which after a certain point a person’s behavior can be seen as distressing, dangerous, dysfunctional and deviant. But there is absolutely no defining line that determines true normality or abnormality.