Positive Health Online

One of the confusing elements surrounding the field of psychology is the concept of 'normal'. People ask themselves and others, "Am I normal? Are you normal?" The popular press has dozens of questionnaires every week which supposedly help the individual to determine his degree of normalcy.

But the question of exactly what do we mean by 'normal' is a complicated philosophic domain which is seldom discussed.

The word 'normal' itself looks like the mathematical term, 'the norm'. Now, 'norm', in the strict sense is a kind of statistical average which can be calculated. But being 'average' is not what the term 'normal' conveys in a psychological context. In a broader sense, we think of a person who is normal as someone who is generally healthy, i.e., not disturbed. This is a clear distinction from the statistical norm; for in a society where most people have a damaged liver, it is in a strict mathematical sense the 'norm' to have a bad liver, but it is certainly not healthy.

Much of the confusion stems from this divergence of those two often-used terms. To clarify this, it is more useful to always consider that in the psychological realm, 'healthy' is more basic than following the general pattern, or 'norm'.

The medical model for determining what is normal is clearly distinct from the psychological one. In medicine, another frame of reference is used: for example, take body temperature in which there is a clear normal range and any measurement following outside of this is deviant and 'abnormal'. As psychologists though, our task is more difficult. It is not always so clear that behaviour which deviates from the 'norm' or average behaviour is necessarily abnormal or unhealthy. In many instances it may be superior to the 'merely' normal or average, i.e. run of the mill activity.

In the realm of psychology, everything is somewhat more complicated, since human behaviour is so diverse and cultural influences indeed also play a part.

And one basic problem is that every psychotherapist has his own notion of what 'human nature' is, and what a healthy person should be like. So in a sense, every psychologist, one might say, sets his own standard for what is and what is not 'normal' according to his own life and inner light. This only adds to our predicament.

I recall from the 1960s there were still some elderly psychotherapists who would only consider patients 'normal' or 'healthy' if they understood the concepts of class warfare and dialectical materialism.

Psychologists who believe in Karl Marx naturally would have his patients all become socialists, whether or not the influence from the therapist is direct or indirect. Most practitioners, however, go in the other direction and stress the patient's adjustment to the prevalent society – cut your hair short, put on a suit, and get a good job. In other words, be a 'success'. I have even met some psychologists who judge the mental health of their patients on the basis of their income! A patient who had worked his way up to a high-paying job was, in this skewed vision, in better shape than one who persisted in a low-level occupation.

During the Vietnam War, the radical, anti-war psychiatrists considered it a step in the right direction when patients could renounce the 'establishment' and oppose the hostilities in Asia.

The classical view in psychology is that individuals must adjust to society. Those who do this well, who are able to 'fit in', are declared healthy. And the others, who are less adept at conforming to society's rules, …well, they are disturbed, or neurotic, or abnormal, or whatever labels the traditionalist may use. However, there are other views on this question. For the humanistic psychologist, the mentally disturbed person is not judged ill merely because he is out of step with society; he is considered in need of help because he's out of touch with himself. A rejection of these archaic 'adjustment' notions of the early Freudian school need not lead us to the negativism of RD Laing's 'anti-psychiatry' nor to Thomas Szasz' labelling nightmare.

In one of his last papers, Freud admitted that psychoanalysis does not yield a high rate of cures (after years on the couch, the analyst would say "this patient is not a case for analysis"; but this does not mean that we must throw up our hands in helpless despair and indulge in nihilistic and romantic fantasies about how wonderful it is to be schizophrenic and anti-society. For the modern psychotherapist, the goal of treatment is not adjustment; it is rather to help the individual to grow, to become more himself... in Abraham Maslow's term – 'self-actualization'. Thus, humanistic psychotherapists do not try to adjust the patient to society, but rather they strive to free him from the difficulties that have limited his development, so that he can become more truly himself.

Fritz Perls had an unusual perspective on this question. He offers the radical notion that in our modern society, no one is really healthy – since all of us suffer from stunted growth. Some people are 'sick' in the common way (what he calls the 'mass neurosis') while others have what Perls calls an 'individual neurosis'. Thus, the individual-neurotics are disturbed in their own peculiar, idiosyncratic way, while the mass-neurotics are those who are unhealthy in the same so-called adaptive, conformist style (e.g., they introject images from the social world, slavishly following the latest trend and having no ideas of their own). But all of us are 'unhealthy' in the sense that no one is truly fulfilling his potential. In fact, Perls believes that most people utilize only a small proportion of their total capacity; a man who uses 25% of his ability is considered a genius.

Perhaps this is an extreme viewpoint, but it does present another view of healthy/unhealthy.