Concepts of Abnormality and Psychological Disorders

Understanding Abnormality: The Four Ds

No single definition of abnormality has ever won universal acceptance, but most definitions share common features known as the four Ds: deviance, distress, dysfunction, and danger. A psychological disorder is typically deviant — different, extreme, unusual, even bizarre. It is distressing, meaning unpleasant and upsetting to the person and to others. It is dysfunctional, interfering with the person's ability to carry out daily activities in a constructive way. And it may be dangerous, either to the person or to others.

This four-part definition is a useful starting point, but it is not the final word. The word 'abnormal' literally means "away from the normal," which implies deviation from some clearly defined standard. In psychology, however, there is no ideal model or even a normal model of human behaviour to use as a base for comparison. Two basic and conflicting views have emerged from the various approaches used to distinguish normal from abnormal behaviour.

Two Conflicting Views of Abnormality

The first approach views abnormal behaviour as a deviation from social norms. Many psychologists argue that 'abnormal' is simply a label given to behaviour that deviates from social expectations. Abnormal behaviour, thoughts, and emotions are those that differ markedly from a society's ideas of proper functioning. Every society has norms — stated or unstated rules for proper conduct. Behaviours that break these norms are called abnormal.

A society's norms grow from its particular culture: its history, values, institutions, habits, skills, technology, and arts. A society that values competition and assertiveness may accept aggressive behaviour, whereas one that emphasises cooperation and family values — such as India — may consider aggressive behaviour unacceptable or even abnormal. Moreover, a society's values change over time, causing its views of what is psychologically abnormal to change as well.

Serious questions have been raised about this definition. It assumes that socially accepted behaviour is not abnormal, and that normality is nothing more than conformity to social norms.

The second approach views abnormal behaviour as maladaptive. Many psychologists believe the best criterion for determining normality is not whether society accepts the behaviour but whether it fosters the well-being of the individual and eventually of the group to which they belong. Well-being is not simply maintenance and survival; it includes growth and fulfilment — the actualisation of potential, as you have studied in Maslow's need hierarchy theory.

According to this criterion, conforming behaviour can itself be abnormal if it is maladaptive — if it interferes with optimal functioning and growth. For example, a student who prefers to remain silent even when they have questions in their mind is behaving in a way that is maladaptive. Describing behaviour as maladaptive implies that a problem exists; it also suggests that vulnerability in the individual, inability to cope, or exceptional stress in the environment have led to problems in life.

Stigma and Misconceptions

If you talk to people around you, you will see that they have vague ideas about psychological disorders, characterised by superstition, ignorance, and fear. It is commonly believed that psychological disorder is something to be ashamed of. The stigma attached to mental illness means that people hesitate to consult a doctor or psychologist because they are ashamed of their problems. In reality, a psychological disorder — which indicates a failure in adaptation — should be viewed like any other illness.

Historical Background: How Views Have Changed

To understand psychological disorders, we need a brief historical account of how these disorders have been viewed over the ages. Certain theories have occurred over and over again.

The Supernatural Perspective

One ancient theory, still encountered today, holds that abnormal behaviour can be explained by the operation of supernatural and magical forces such as evil spirits (bhoot-pret) or the devil (shaitan). Exorcism — removing the evil that resides in the individual through countermagic and prayer — is still commonly used. In many societies, the shaman or medicine man (ojha) is believed to have contact with supernatural forces and is the medium through which spirits communicate with human beings. Through the shaman, an afflicted person can learn which spirits are responsible for their problems and what needs to be done to appease them.

The Biological or Organic Approach

A recurring theme in the history of abnormal psychology is the belief that individuals behave strangely because their bodies and brains are not working properly. This is the biological or organic approach. In the modern era, there is evidence that body and brain processes have been linked to many types of maladaptive behaviour. For certain types of disorders, correcting these defective biological processes results in improved functioning.

The Psychological Approach

According to this point of view, psychological problems are caused by inadequacies in the way an individual thinks, feels, or perceives the world.

Historical Development in the West

All three perspectives — supernatural, biological, and psychological — have recurred throughout the history of Western civilisation.

In the ancient Western world, philosopher-physicians of ancient Greece such as Hippocrates, Socrates, and especially Plato developed the organismic approach. They viewed disturbed behaviour as arising from conflicts between emotion and reason. Galen elaborated on the role of the four humours in personal character and temperament. According to him, the material world was made up of four elements — earth, air, fire, and water — which combined to form four essential body fluids: blood, black bile, yellow bile, and phlegm. Each fluid was responsible for a different temperament. Imbalances among the humours were believed to cause various disorders.

In the Middle Ages, demonology and superstition gained renewed importance in the explanation of abnormal behaviour. Demonology related to a belief that people with mental problems were evil, and there are numerous instances of 'witch-hunts' during this period. During the early Middle Ages, the Christian spirit of charity prevailed, and St. Augustine wrote extensively about feelings, mental anguish, and conflict. This laid the groundwork for modern psychodynamic theories of abnormal behaviour. …