Download PS_280_1_overview_and_defining_abnormality

DEFINING “ABNORMALITY” OR
CONSTRUCTING PSYCHOPATHOLOGY?:
LECTURE OUTLINE
• Some warnings about “abnormality”
• Difficulties defining abnormality
• Thomas Szasz (1960) – the myth of mental
illness
• Rosenhan (1973) – on being sane in insane
places
• Myths and misconceptions
• Various ways of defining abnormality
SOME WARNINGS
• Clinician’s bias – look for abnormality and
you will find it
• Tendency to focus on problems and ignore
the whole person and her/his strengths
• Fundamental attribution error – tendency to
downplay the importance of the environment
as contributing to problems – are people
“abnormal” or doing the best they can to
cope in stressful circumstances?
SOME WARNINGS
• Words can hurt – “crazy”, “wacko”,
“psycho” are inappropriate
• All this can lead us to turn the individual
into one of “those people,” uncovering
societal prejudices towards people with
mental health problems that we may have
internalized
SOME WARNINGS
• So, focus on the person first, the problem
second; and look at the person in context
• Use “people first” language – person’s
proper name or more generally, e.g.,
“person experiencing depression”; avoid
language like “a schizophrenic”
SOME WARNINGS
• Pay attention to how mental illness is
portrayed in the media
• Use STOP criteria to think about stigma –
Stereotype, Trivialize, Offend, Patronize
• Recognize the potential for recovery
• Think critically, be a skeptic, question
current views!
DIFFICULTIES DEFINING ABNORMALITY
• What is considered to be “abnormal” is a
value judgment, assumption that normality
is clearly defined. But what is normality?
• Some warning signs for normality –
serious, nice, always right, boring,
obedient, gullible (Janet Foner, Support
Coalition Survivor and Psychiatric
Survivor) – please note this is a joke!
DIFFICULTIES DEFINING ABNORMALITY
• Values depend on social context, and
values and social context are variable
• Are individuals abnormal or are social
conditions stressful?
• Defining abnormality is a social act
THE MYTH OF MENTAL ILLNESS
• Psychiatrist Thomas Szasz argued that
mental illness does not exist, but rather
problems in living
• No known lesions, defects, or diseases of
the nervous system underlie any mental
illness
• “symptoms” of mental illness are not
linked to anatomical context, but to social
context
THE MYTH OF MENTAL ILLNESS
• Deviation from social norms is judged by
mental health professionals
• Whose agent is the mental health
professional? (the person, relatives,
organization, the state)
• Psychiatry is different than other
branches of medicine, more tied to
problems of ethics and values
ROSENHAN (1973) – ON BEING SANE IN
INSANE PLACES
• 8 “pseudo” patients sought admission to
hospitals
• voices – “empty”, “hollow”, “thud”
• no simulation of symptoms after
admission
• all except 1 admitted with diagnosis of
schizophrenia, discharged with
“schizophrenia in remission”
ROSENHAN (1973) – ON BEING SANE IN
INSANE PLACES
• this is an example of the clinician’s bias
• detection
• “stickiness” of diagnostic labels - stigma
• experiences of hospitalization
• powerlessness and depersonalization
MYTHS AND MISCONCEPTIONS
• People with mental illness are strange
and different
• People with mental illness should be
treated differently
• Mental illnesses are inherited
• Mental illnesses are incurable
• Mental illnesses are caused by the
stresses of modern life
MYTHS AND MISCONCEPTIONS
• Mental illness and genius go hand in
hand
• Mental illnesses is caused by personal
weakness and can be overcome through
will power
• People with mental illness are irrational
and dangerous
• People with mental illness need to be
hospitalized
MYTHS AND MISCONCEPTIONS
• People with mental illness are poor
• People with mental illness are less
intelligent than others
• All homeless people are mentally ill
• Mental illness is a single, rare disorder
SUMMARY
• Abnormality and mental illness are
problematic concepts because of values
and social context
• Remember that mental illness is not
something absolute and unchangeable, but
a concept that is constructed in a social
context