It is necessary to ask questions such as: is there a line that distinguishes "normal" from "abnormal"? and how do people know when it has been crossed? According to Orozco (2014), many persons with severe mental problems can make the most of certain aspects of their lives, while other individuals, who are considered normal, show maladaptive behaviors that disturb others.
Faced with this situation, how should health services, especially mental health professionals, deal with it? Although, according to Orozco (2014), it is not easy to establish what is "normal" and what is "abnormal", part of the work of clinical psychologists is based on the belief that people can modify their behaviors, thoughts and emotions to improve their quality of life.
What Aspects Constitute a Psychopathology?
No single behavior can make a person "normal" or "abnormal" (Butcher, Mineka & Hooley, 2007). This constitutes a problem in determining the existence of mental disorders. However, there are certain elements that may indicate the manifestation of a pathology. According to Butcher, Mineka & Hooley (2007), the more elements a person accumulates, the more likely he or she is to develop some type of mental disorder.
Suffering
If an individual experiences psychological suffering, people are generally inclined to consider that suffering as an indicator of some pathology (Butcher, Mineka & Hooley, 2007). People with depression suffer, as do people with anxiety disorders, but what about people with mania? According to Butcher, Mineka & Hooley (2007), they may not be suffering; in fact, many of these patients do not want to take medication because they do not want to lose the manic phase.
However, it is possible that when examined, this person is suffering, nevertheless, it is strange to consider this suffering as something "abnormal" (Butcher, Mineka & Hooley, 2007). Although pain is a pathological factor in many cases, it is never a sufficient or even necessary condition to consider something pathological (Butcher, Mineka & Hooley, 2007). In short, Carvalho (2017) states that, although it is a criterion of great value, it should be recognized that this does not imply that the information obtained by a person is reliable, and may not identify their problems or discomfort and even feel well in appearance.
Maladaptation
Maladaptive behavior impedes a person's overall development, i.e., it renders an individual unable to feel good and is seen by others as inconsistent and uncomfortable (Orozco, 2014). Therefore, in accordance with Butcher, Mineka & Hooley (2007), maladaptive behavior is also often an indicator of pathology.
Most people with mental illness manifest themselves through maladaptive behavior, however, this does not necessarily represent a transgression of social norms (Orozco, 2014). For example, people with anorexia nervosa may decrease their food intake to levels that require hospitalization (Butcher, Mineka & Hooley, 2007). Similarly, consistent with Butcher, Mineka & Hooley (2007), people with depressive disorders may stop seeing family and friends and may lack the motivation to work for weeks or months.
Maladaptive behavior can affect well-being and the ability to enjoy work and social relationships; however, not all illnesses involve maladaptive behaviors (Butcher, Mineka & Hooley, 2007). For example, a con artist or a hired killer may have antisocial personality disorder. The former may be an expert at getting people to give him information about their finances, while the latter may be quite capable of killing someone for money. Is this maladaptive behavior? Of course not for them, since that is their way of life. However, according to Butcher, Mineka & Hooley (2007), these people are believed to be "abnormal" because they are socially maladaptive and unbalanced in society.
Deviance
The word "abnormal" literally means out of the ordinary. However, resting to consider a statistically rare behavior as abnormal does not provide any solution to the definitional issue (Butcher, Mineka & Hooley, 2007). For example, geniuses are statistically rare, but this does not necessarily make them "abnormal". Conversely, intellectual disability is also statistically very rare, yet this condition is considered a pathology. This indicates that defining what is a pathology requires a value judgment. According to Butcher, Mineka & Hooley (2007), if something is statistically rare and undesirable, it is considered more pathological than that which is statistically rare but highly desirable.
Violation of Societal Norms
This criterion refers to social regulation (Carvalho, 2017). This approach is actually not so different from the previous one, although, instead of applying a quantitative component, it does so qualitatively, which, traditionally, has led to value judgments. That is, the risks of this criterion lie in who or what (Carvalho, 2017). This is because the boundaries between normality and pathology for certain types of behaviors vary from one culture to another (American Psychological Association, 2013), since, according to Butcher, Mineka & Hooley (2007), all cultures have different norms, of which, some of them are expressed in law, while others are less explicit.
While many of the social rules are relatively arbitrary, it is often assumed that when a person violates them they are behaving abnormally (Butcher, Mineka & Hooley, 2007). Of course, this depends largely on the severity of the offense and the prevalence of rule violations in society. For example, most people have double-parked, yet violation of this rule is so common that it is not considered to be abnormal behavior. However, if the mother drowns her child in the bathtub, according to Butcher, Mineka & Hooley (2007), it is immediately thought of as abnormal behavior.
Social Awkwardness
When a person violates social rules, those around him or her may become uncomfortable (Butcher, Mineka & Hooley, 2007). For example, suppose you are taking a bus home and the driver is the only occupant besides yourself. At a stop, the bus stops for another passenger to get on, even if there are many empty seats, he or she will sit next to you. how would you feel? Similarly, if a person you've known for only a few minutes starts telling you about his or her suicide plan, how would you feel? According to Butcher, Mineka & Hooley (2007), unless you are a psychologist working in a crisis intervention center, you might think this is abnormal behavior.
Irrationality and Unpredictability
People expect others to behave in certain ways (Butcher, Mineka & Hooley, 2007). While a little nonconformity can add some sparkle to life, sometimes excessively unorthodox behavior is considered abnormal. For example, if the person sitting next to you suddenly starts shouting loud obscenities without addressing anyone in particular, you may think you are engaging in unusual behavior. According to Butcher, Mineka & Hooley (2007), this is unpredictable and meaningless.
The disordered speech and disorganized behavior of patients with schizophrenia is often unreasonable (Butcher, Mineka & Hooley, 2007). However, these behaviors are also the hallmark of the manic phase of bipolar disorder. Indeed, if a person begins to recite an excerpt from Fuente Ovejuna, one may not panic if one knows that he or she participated in the play. However, according to Butcher, Mineka & Hooley (2007), if a person is found rolling on the floor while reciting Shakespeare, he or she may be advised to seek help.
References
Butcher, J., Mineka, S., & Hooley, J. (2007). Psicología clínica (12a. ed.). Distrito Federal: Pearson Educación.
Carvalho, C. (2017). Psicopatología Clínica: definición y objeto de estudio. Hablemos de Neurociencia. Recuperado 15 September 2021, a partir de https://hablemosdeneurociencia.com/psicopatologia-clinica-definicion-concepto-objeto-estudio/
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5®). (2013). Washington, D.C.
Orozco, S. (2014). Normalidad y anormalidad psicológica y niveles de prevención. studylib.es. Recuperado 12 January 2021, a partir de https://studylib.es/doc/5504790/normalidad-y-anormalidad-psicol%C3%B3gica-y-niveles-de-prevenci%C3%B3n
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