Well, it is one of the most difficult questions to answer. Psychiatrists have to face this question frequently. We happen to see grossly abnormal, psychotic person asserting that he is normal; on the other hand many apparently normal persons approach us with the above question. The truth is that there is no absolute yardstick to measure whether one is normal or not. But this is so even in the most branches of biology.
We can define an average Indian male citizen as a person with X cms of height, Y kg of weight, Z color of skin, M color of eyes etc. But such a person may never exist in real world !. This normality is based on statistical calculations.
We may also define normality by other methods. All are presumed to be healthy unless found to have an abnormality or a symptom. This is a presumptive criterion used in community health.
Normality can also be thought of as an ideal or utopia. It can also be viewed as a dynamic state or as a process.
I am stressing this difficulty as I think it is important that we are aware of the limitations in judging others. With this background only we can start the discussion on mental health, illness, creativity and psychopathology.
We have to accpet that even the most normal of us can have certain queer or abnormal behaviors in some situations.
ഇന്ത്യ
2 weeks ago
7 comments:
thank you for starting this most relevant topic. if a person says he believes in ghosts, it is considered a perfectly normal view to hold, generally speaking. But if the same person says he sees ghosts, then people look askance at him. And advise him to see a psychiatrist. They are perfectly able to reconcile with his belief, but not his experiences.which is totally consistent with that belief. Is there any psychological basis for such contradictory behaviour, or is it merely a cultural matter of no significance ? Thanj you .
what i wanted to ask in the earlier post was this, but did not put it with clarity. We have an instinct for self-preservation in the physical domain which clearly says 'thus far and no further' , whatever our desires and fantasies may be, say, jumping off a cliff or flying like a bird, Is there an equivalent self-preservation instinct in the metaphysical domain that helps people to realise when they are likely to tip into insanity and they step back from the brink, irrespective of their beliefs or ideologies ? And people who cannot do this are basically evolntionary drop-outs ? Thank you
Believes/imaginations/ etc are considered normal as long as a person himself recognises them just as his imaginations and not as a reality...to believe them as real ,the society in which he lives should agree(whether right or wrong is immeterial) with his views....
A novelist can earn money if he write down his imaginary world as a novel and publish...and if believes and act as if his imaginary world/story is actual/ true, he will be able to enjoy free food and accomodation in a saitorium .
Belief in paradise is socially accepted.But seeing or experiencing it before death is not expected by the society....so it is the expectations or norms of the society which decides the saneness of it's members...
Am I right Sashi?
Thank you.
Grading the abnormality in some cases appear to be very difficult and it becomes extremely difficult in the cases of mild mental / brain disorders. There are two points here I want you to take a look, one is that you have the option of not treating a minor case at all. It is not necessary to treat a common cold or a usual viral fever, but it is recommended to closely watch for the symptoms to worsen or wait for a secondary infection to develop. Also a person has all the right to get treatment for a common cold if he requests it. The same principle can be applied to psychiatry also, though there are some problems with egosyntonic persons. We can force egosyntonic persons with severe mental/brain disorders for the treatment because we do the same thing in other specialties also. You will definitely opt for treatment if a person has consistent blood pressure levels of 160/120 or another person with a total cholesterol level of more than 400. The second point I want to discuss here is, will these problems are here to stay forever or not? I hope it is a matter of time. Science and technology are evolving so fast that we may get much better objective tools for assessing the abnormality soon. Now we have a genetic test for Huntington’s disease, am I right? One day it may be possible to diagnose mental/brain disorders with objective tools such as Lab results, Scanning results, Gene mapping etc… MR scans of people with mental/brain disorders show us a promising future in grading the abnormality. Think of diagnosing hypertension without a sphygmomanometer or diabetes without any laboratory examination results. There was a tough time for doctors before all this marvelous technological equipments developed. It is easier with DSM IV TR than using DSM I to grade or classify mental/brain disorders. So the question “Am I mentally normal?” is a dissolving one, it may be dissolving faster than we hope. Some grossly abnormal, psychotic persons may state that they are perfectly normal but we do not have to listen to them, at least for practical purposes. We listen to judges when we have a legal problem, we listen to an engineer when we need to build a bridge or a home. It is the opinion of the experts that matter. Society is expected us to behave in a particular way, though some small mutations are allowed.
Hi Sashi,
You know that believing in ghosts can considered as delusion and seeing ghosts is hallucination. A person may seek professional help in the first case but it is not necessary. The may become a must in the second case. Compare it like common cold vs. acute bacterial sinusitis. It is all relative. I do not want to get in to a controversial subject but it is observed that society teaches us to believe in gods and ghosts from our childhood but they don’t expect us to see gods or ghosts. So the delusion of ghosts or gods is induced by the society but the hallucinations of seeing gods or ghosts are more pathological in nature. A person who see ghosts are more probable to have other forms of mental/brain disorders than a person who only believe in a ghost. Imaging studies also may show difference in the case of a person who see ghosts. Seeing or talking to ghosts may not be considered a problem in a tribe or society where that is supposed to happen to all members. There is a cultural matter of significance, but only in some rare cases.
An equivalent of self-preservation instinct in the metaphysical domain may not be possible. In the cases of mental/brain disorders, the very organ affected is the brain that is also the producer of both the metaphysical world and the self-preservation instinct. Objective decision making becomes a problem when the brain becomes unhealthy. Still there are some people who realise when they are likely to tip into insanity and they step back from the brink, irrespective of their beliefs or ideologies. They seek professional help at the right time. Some genes may play for this, I do not know for sure. And people who cannot do this may be evolutionary drop-outs. But I like to take a different stand, the so called self aware psychotics are a step ahead in the genetic space.
Extremely sorry to write such a big comment here, I am a talkative guy in the writing space. But as you said “These chats will protect us from Alzheimer's disease, if nothing else!
Thank you all.
hahahaha devdas, you do have a sense of humour. You are right that a society decides whether a person is sane or not, but whether that is the ideal way is the question. we have noticed that there is an inherent inertia in any society to the process of change.so there is a danger that some prejudices or misinterpretations that existed at a certain time would define insanity for all time. So a progressiue society leaves it to specialists like harish to interpret the malady and its cure, and rightly so. And generally accepts the specialists views. Some societies indulge in barbaric acts like beheading people in public, although i think if they had taken a psychologists opinion. They would have been definitely advised against exposing people to such barbarism. Thanks ajeesh for pointing out the impracticality of the self-preservation instinct arising in the brain because its the very organ rendered dysfunctional in an insanity situation. So this seems to be the only field of medicine where the opinions of the patient need not be a factor in imposing a treatnent regine on him, without aoy ethical dilemma to cloud the treatment process. You just provided a good argument for that. harish I am sorry that a couple of penpushers, or more precisely keypad pushers have hhjacked your blog ! Thanj you
A society's expectations may not be rational all times. Here is a quote from wikipedia.
"In the United States of America, prior to the American Civil War, psychiatrists, such as Samuel A. Cartwright, diagnosed some slaves with drapetomania, a mental illness in which the slave possessed an irrational desire for freedom and a tendency to try to escape slavery."
I am really happy to see the turn the discussion has taken. I do not feel u all have hijacked my blog. I am even more happy to see Devadas joining back in the action. All the points raised are valid. It is true that diagnosing mental illness is problematic because of the lack of objective tools. Because of this psychiatry has been abused by totalitarian regimes in many countries. This is why the practice of psychiatry is regulated by special laws in most countries, unlike other branches of medicine. We do not have specific laws like Indian Pediatrics Act or Indian Cardiology Act. But we do have a Mental Health Act. The terms and concepts used in the field of mental healh are defined by law and subject to interpretations by courts.
I earnestly hope for the invention of a device that can detect a mentally unsound person. Then any doctor can order the test and find out whether his patient is normal or not. This will reduce the stigma asociated with mental illness> National Alliance for the Mentally Ill (NAMI)a major NGO fighting for the mentally ill, promotes use of the term "brain disorder" instead of "mental illness" to reduce stigma.
I am really amazed to read the discussion on difference between seeing and believing in ghosts. Really wonderful way of explaining things. I can even use this example for my PG classes.
Regarding the issue of applying brakes to imagination: We do not touch hot objects as we have learned form others or by self experiment that it hurts. But unfortunately, it may be really difficult to stop short of going beyond the Line of Control in the mental world. I shall write a post on thinking to clarify this.
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