This approach can lead to a form of social determinism, which means a person’s abnormality is defined in terms of their audience rather than in terms of what they are like as individuals.
Another example of the social conformity approach is homosexuality. This is abnormal not because it is statistically less common than heterosexuality but because heterosexuality represents societies ‘normal’ state of sexual relationships. From a religious/moral perspective, homosexuality might be judged as ‘bad’ or even ‘sinful’, while from a more biological/scientific perspective, it might be labelled ‘sick’ or even ‘perverse’.
(Hayes 1994)
Even if the majority of men and women engaged in homosexual relationships making heterosexuality abnormal according to statistical criterion, this would still be considered a deviation from the ‘norm’ and therefore abnormal.
(Gross 1992)
For 23 years up till 1974 homosexuality was defined as a mental illness by the American Psychiatric Associations official diagnostic manual. Nothing happened to homosexuality after this time, but what changed were societies attitude towards it, which then reflected in its official psychiatric status.
(Gross 1992)
Behaviour may be considered normal or abnormal depending on the situation or context. Taking off your clothes to get in to the bath is fine; taking off your clothes to go to the shops naked is not. What determines the judgement of normal or atypical are the social expectations of the situation you find yourself in. (‘situational norms’). There are also then the ‘developmental norms’; this is where normality or abnormality is judged depending on the development age of the person. For example, temper tantrums are very normal for 2 year olds, but very abnormal for 32 year olds.
(Gross 1992)
Allman & Jaffe (1976) argue that basic divisions such as normal and abnormal are attempts by society to structure and regulate the world. They say that normal/abnormal means acceptable/nonacceptable, however it is down to whether society will tolerate it or not.
According to Rosenhan & Seligman (1984), there are seven properties that can be used to help decide whether a person’s behaviour is abnormal.
They are as follows: -
- Suffering
- Maladaptiveness
- Irrationality
- Unpredictability
- Vividness and unconventionality
- Observer discomfort and
- Violation of moral and ideal standards.
These properties define abnormality, and focus on the distress of the individual. The first four are concerned with how the person is living their own life. The fifth is borderline, and the sixth and seventh are the ones that are about what behaviour is considered to be socially acceptable and what is not.
(Hayes 1994)
However there is a problem with these properties. There is an increasing awareness of how psychiatric diagnosis of women and some ethnic minorities has been misapplied, this is because of white middle class and predominantly male psychiatrists, who fail to understand the cultural ‘norms’ of the groups that their patients have come from. This means that different psychiatrists may end up applying different diagnoses.
(Gross 1992)
The most famous study on the problems with diagnoses is the one of Rosenhan (1973) called “On being sane in insane places”. He arranged for eight ‘normal’ people to go to the admissions office of an assessment mental hospital and pretend to be sick. These included a psychology student, three psychologists, a paediatrician, a psychiatrist, a painter and a housewife. They all pretended to have just one symptom; they all said they heard voices. Apart from false names and occupations all other details given to medical staff were true.
All subjects were admitted for treatment, and seven out of the eight were diagnosed as having schizophrenia. As soon as they were admitted each participant acted normally and said the voices had gone. Some started to keep diaries of the time they spent there and the medical staff would keep note on them making notes. The confederates of the experiment went undetected, however they were regarded as being disturbed by the medical staff.
It took between seven and fifty-two days before they were discharged. When released they were diagnosed as being `schizophrenic in remission', not as being sane.
According to Rosenhan, doctors are most likely biased towards committing type-one errors. This is when they play safe; causing a doctor to diagnose healthy people as sick more often, than sick people as healthy. This is also called a false positive. A type-two error is the other way round; diagnosing sick people as healthy, and is also known as a false negative. ()
A follow up experiment was arranged at another hospital. Roesenhan doubted that hospital staff would commit type-two errors. They were warned that over the next three months one or more fake patients would present themselves for admission at their hospital. The staff were asked to make judgements on a 10 point scale. Forty-one patients were detected by at least one member of staff. Twenty-three were suspected by at least one psychiatrist. A psychiatrist and one other member suspected nineteen. In fact, no fake patients had been presented.
()
If Rosenhan’s findings are valid, it appears that psychiatrists are unable to tell the difference between the sane and the insane, and that the psychiatrist’s classification of mental disorder is unreliable, invalid and harmful to the patients. However Rosenhan’s study has been criticized by Spitzer (1976), he said that Rosenhan should have known that the terms sane and insane are legal not psychiatric concepts, and no psychiatrist makes a diagnosis of ‘sanity’ or insanity’. He also said that Rosenhan’s pseudo-patients were give a discharge diagnosis which is hardly ever given to real patients with an admission diagnosis of schizophrenia, and that the diagnoses were a function of the fake patients behaviours and not the hospital as Rosenhan claimed.
(Gross 1996)
An alternative approach to define odd behaviour is to try and define normality rather than abnormality.
Humanistic psychologists regard abnormal behaviour as the failure to achieve self-actualisation. The humanistic approach casts the problem in a different light, not as that of defining abnormality but as that of defining normality.
Jahoda (1958), looked at ‘optimal living’, in other words, this is what a person needs to get the most satisfaction, enjoyment and fulfilment out of their life while also making a positive contribution to society.
There were six elements for Jahodas ‘optimal living’.
They were: -
- Positive attitudes towards self
- Growth and development
- Autonomy
- Accurate perception of reality
- Environmental competence
- Positive interpersonal relationships.
(Hayes 1994)
To conclude; explanations for atypical behaviour have changed throughout the last fifty years and means it is very difficult to define normal and abnormal behaviour, this is shown in Rosenhan and Jahoda’s experiments.
We saw when we examined homosexuality that societies views are always changing, this means that classifications of atypical behaviour are always changing too. It is clear that society plays a huge part in deciding what is acceptable and non-acceptable, and therefore draws a fine line between normal and abnormal behaviour, which in my opinion cannot be drawn due to different individual people and different cultures around us.