Interview with Forsakken

A Little on Abnormal Psychology

  
Abstract

In this paper I will look at what defines abnormal psychology.  When considering this I will take issues such as culture, ethnics, religion and spirituality, and a person’s circumstances into consideration while attempting to define what abnormity is.  After that I will delve into different problems and disorders and attempt to define what is normal or not concerning these issues.  Labeling is something often done in our society so I will take a brief look at the problems and advantages of labeling.  Lastly I will take a look at psychology and the law and explain my feelings on a few problems that could be presented. 

Defining “Abnormal”

To be able to distinguish whether or not something is abnormal, the term “abnormal” needs to be defined.  Deviance can be a sign of abnormality where behaviors are out of the norms of a particular culture.  However, deviance alone generally would not qualify as one being abnormal.  Someone who likes to spend a lot their time alone may seem deviant to some people, yet this would not necessarily qualify someone as being psychologically abnormal.  Yet, someone who claims that they have been abducted by aliens on several accounts may indicate an abnormal behavior is present.  Distress can be a sign of abnormality, however abnormality can be present without distress as well.  A person who is schizophrenia may find great joy in a certain voice they hear, however, distress may be found in disorders such as depression, eating disorders, suicide, personality disorders, stress, etc.  If a person is not functional in society such as not being able to hold a job, keep relationships, or has other trouble being able to function may be a sign of abnormally.  Finally a person who is a danger to themselves or others may be indicative of abnormality (Comer 2008), however, most with psychological abnormalities are not dangerous (Corrigan & Watson as cited in Comer 2008).

I believe there is much gray area in defining what psychological abnormality is.  For instance, if someone likes music that is generally not enjoyed by most people of a society that does not cause reason for psychological concern.  There might be some people who seem to gravitate toward some of the psychological orders mentioned in the textbook “Abnormal Psychology” yet may be considered normal.  A person who sometimes feels empty and struggles with mood control may not qualify for Borderline Personality Disorder.  Feelings of distress are normal in times of grief such as death of a loved one, break up of a marriage, struggling with disobedient children and so on.  While it may be appropriate for people in these circumstances to seek professional psychological help, they may not be classified as “abnormal.”  A person who is not functional in such things as keeping a job may not necessarily be abnormal.  Perhaps he has been attempting to get jobs that requires him to use talents that he doesn’t have. 
           
Culture and differing ethnic groups play a roll when defining normality.  For instance, Native Americans are known to have a very strong attachment to their land and nature.  When their land was taken from them, this may play a factor in the increased rates of depression, suicide, and alcoholism among this group of people.  While in the United States suicide may be linked to other abnormal psychological problems, suicide and honor have a historical link in parts of Asia.  Ethnic groups that are victims of racism and discrimination may appear to have higher rates abnormal behavior among these people. 
           
The religious aspect of culture plays a roll in defining normality.  One example would be that one might walk into a Pentecostal church and observe many of the members yelling out a bunch of “gibberish” that doesn’t make sense.  To the observer this may appear to be abnormal, yet many of the people in this church may believe that they are speaking in a prayer language of some sort often referred to as “speaking in tongues.”  One may hear that a Gardnerian Wicca ritual is done sky clad (in the nude) with several people and may view the people involved as being sexually deviant.  However, the people performing this ritual may do the ritual sky clad just to simply feel closer to nature.  
           
In order to define abnormality, such things as culture, religious beliefs, life’s circumstances, racial group, etc. need to be taken into consideration when working with a patient.  I’m going to take a look at some of the disorders in the book and give my opinion as to whether or not they should fall under the label of “abnormal.”
Anxiety Abnormality
           
When it comes to anxiety, we all struggle with it to a degree.  There are phobias many of us have that are nothing more than an irritation.  Maybe one gets a little uncomfortable in an elevator due to claustrophobia but can still normally function.  This same person may not be able to handle a Native American sweat lodge and becomes heavily anxious and needs to remove herself.  Being that a sweat lodge is very enclosed with no light and highly elevated temperatures, anyone with a degree of claustrophobia may react this way.  I would not consider this person to have an abnormal phobia.  However, if another person reacts in the elevator the same as the previous person reacted in the sweat lodge then perhaps this person’s phobia is abnormal.  I would say it is similar to all the anxiety disorders that it would depend on the degree to which one is affected before it would be considered “abnormal.”  Life’s situations would definitely play a role when it comes to anxiety.  One who lives in an area with a high crime rate may struggle with higher anxiety levels than one who lives in an area that is known to be safe.  So to classify one as having abnormal anxiety they would need to demonstrate unreasonable anxiety in a setting that wouldn’t trigger that reaction for most people. 

Stress Abnormality
           
I would not consider acute stress disorder as being necessarily abnormal.  A person who goes through an extreme stressor will likely be affected for a month.  For instance, a person who gets in a severe car wreck may continue to feel stressed about driving for a time period.  I would consider this normal, especially if it wears off within a month such as the case with acute stress disorder (APA 2000 as cited in Comer 2008).  I would definitely recommend some sort of therapy sessions for a person who has gone through something like this to quicken the healing process but I wouldn’t label it as “abnormal.”  Posttraumatic stress disorder I would have a similar view as I do with the anxiety disorders in that it would be the degree as to which one is affected by the PTSD.  If a soldier who has been at war and ten years later were still struggling with highly elevated stress levels due to the memories of battle I would consider this to be more on the side of “abnormal.”  This would be abnormal because this person’s life is still being disrupted several years after the onset of the stress and he hasn’t been able to return to a normal functioning life.   On the other hand, if someone feels a tinge of anxiety or stress when a memory of the stressful event comes about, but the person remains in control of himself or herself I would not consider this abnormal. 

Somatoform and Dissociative Disorder Abnormalities
           
I would consider somatoform disorders to be abnormal due to the fact that such a disorder can severely interfere with one’s life.  Such a disorder may cause one to not be able to function properly in society.  For instance, someone who works a job that requires physical labor may suddenly have a much more difficult time performing tasks due to psychological causes of a physical problem they are undergoing.  Or perhaps a person with hypochondriasis lives a low quality of life because of the constant fear that they have encountered some illness.  Similar with body dysmorphic disorder where someone is overly concerned with a perceived defect in their appearnace (Comer 2008).   Again, the degree at which a dissociative disorder is present would probably define whether it is abnormal or not.  For the most part I wouldn’t consider dissociative amnesia to be abnormal, however in extreme cases of generalized amnesia and continuous amnesia I would probably consider as being abnormal.  Dissociative fugue, while being an abnormal behavior, usually isn’t something that lasts very long and people usually can return to their normal lives without a relapse (Comer 2008).  However, I would consider dissociative identity disorder to be abnormal because it can be disruptive to one’s life.  It seems that one has little control over when the personality changes so it could happen anywhere at anytime.  Such a disorder may create problems in social relationships if one of the subpersonalities isn’t so easy to get along with for example.

Mood Disorder Abnormalities

Depression and mood disorders are another one in which I would consider “abnormal” if they reach a certain degree.  The death of a loved one, job loss, divorce and those sort of things can enhance feelings of depression and trouble with moods.  An elderly person who has just lost their spouse will likely struggle against feelings of sadness and may need counseling, however I wouldn’t consider this abnormal because most people would feel sadness in this person’s situation.  However, for example, a middle aged person who falls into deep depression after a job loss and won’t bounce back out of this depression may be classified as “abnormal,” especially if it affects every day functioning such as taking showers, preparing food, etc.  However, one who suffers depression due to such things as abuse I do wouldn’t consider abnormal.  I would consider their circumstances abnormal and perhaps the learned helplessness influences the person to develop major depression.  However, some people with major depression may have a chemical imbalance such as low activity of norepinephrine and serotonin, which would signify a psychological abnormality (Comer 2008).  Similar with bi-polar disorder, if the manic and depressive stages aren’t extreme enough to disrupt a person’s life I wouldn’t consider them abnormal.  However, if the manic stage is causing uncontrollable urges to act upon extreme ideas that may end up having a negative impact on one’s life or if there is a biochemical factor involved, then I would classify this behavior as being abnormal.    

Suicide and Abnormality
           
As I mentioned above, culture could play in a role of suicide.  I would not consider suicide abnormal under every circumstance.  Someone who suffers from chronic pain from a disease that cannot be cured may not be able to withstand the increasing pain day after day and may long for death (Erlangsen et al.; Hendin as cited in Comer 2008).  Similarly for those in other extreme circumstances where one is in an abusive environment, it may be extremely difficult to have enough hope to endure the uncertainty of the pain and trauma one will face in the future.  In other instances, suicide itself may be more of the result of other abnormal problems such as depression, personality disorders, and maybe schizophrenia (Comer 2008).  It could also be the result of circumstances in life such as divorce, financial set back, lack of fulfillment, etc. (Jacobs et al, 1999).  I would consider suicide an abnormal behavior under these circumstances because there are other ways to cope rather than to end one’s life.  Ending one’s life may have a dramatic impact on those surrounding the person.  A person who fails at suicide should be talked to and tested to see if they have psychological abnormalities that can be treated in order to prevent further attempts. 

Eating Disorder Abnormalities

I would consider eating disorders to be abnormal and they may be the symptoms of other abnormal problems in a person such as depression, anxiety, among other problems.  Both anorexia nervosa and bulimia nervosa are harmful to the one who is suffering from it.  However, going on a normal healthy diet to lose weight and anorexia nervosa are two very different things.  A healthy diet would still require enough calories to remain in good health whereas a person with anorexia nervosa will be eating such a small amount of calories that it will end up becoming harmful to this person’s body (Katzman; Tyre as sited in Comer 2008).  Bulimia nervosa also causes problems such as destruction especially in the teeth, mouth, and throat.  A therapist may want to work on such things as depression, low self-esteem, anxiety and other such behaviors when trying to help a person to recover from an eating disorder. 

Substance Disorder Abnormalities
           
Substance disorders are often abnormal as they can have serious consequences to the person addicted along with those around him.  Interestingly, substance disorders may be the result of abnormal psychological issues, yet can create abnormal behaviors in those who didn’t have them prior to taking the substance.  For example, a person with an anxiety disorder may start drinking alcohol to the point of where it becomes an addiction and this may lead to major depression and this behavior also can affect the children around them causing psychological disorders (Hall & Webster; Mylant et al. as cited in Comer 2008).  Hallucinogens can cause one to have symptoms of schizophrenia even if one has never had the disorder.  Someone who drinks alcohol would not necessarily be considered abnormal.  It’s when the alcohol consumption becomes regular enough where a person needs it to get by in life and begins having an unhealthy affect on this person. 

Sexual Disorders and Gender Identity Disorder Abnormalities

If someone has hypoactive sexual desire or sexual aversion I would question whether or not this person is struggling with anxiety problems, stress, depression, obsessive-compulsive symptoms or other psychological abnormalities (LoPiccolo as sited in Comer 2008).  If this is the case then I would consider it to be a psychological abnormality if the issue is persistent and interferes with one’s quality of life.  However, lack of sexual desire may also be more of a biological issue with hormones more so than a psychological issue.  I would throw the sexual disorders of excitement in this category too along with male orgasmic disorder.  I do not think that in most cases that premature ejaculation is an abnormality.  It could be that the man hasn’t trained himself to restrain from ejaculation for an extended period of time, or that he doesn’t have intercourse very often making premature ejaculation harder to control.  Also, since around 29% of American men experience this, it isn’t all that uncommon (Comer 2008).  Same thing with female orgasmic disorder because of its frequency (24% of females) and the fact that many clinicians don’t believe that female orgasm is necessary for normal sexual intercourse (Comer 2008).  Vaginsmus could be a psychological abnormality if it is due to a learned fear response and not due to a physical problem such as an infection.  Dypareunia tends not to be a psychological problem since it usually has a physical cause (Bergeron et al.; LoPiccolo as sited in Comer 2008).  Yet in some cases it could be psychological if it is the psychological aftereffects of sexual abuse (Binik et al.; Pukall et al. as cited in Comer 2008). 

While I would consider many of the disorders in the paraphilia section as being abnormal I wouldn’t consider them all to be.  For instance transvestic fetishism seems to be pretty harmless and is only demonstrating one’s preferred mode to achieve arousal.  While this behavior may not be what most people do, I see it more as a preference of life style more so than something that needs to be labeled “abnormal”.  A comparable example would be that while most people don’t like the sound of death metal music, those that do wouldn’t be labeled abnormal because of their preference.  I would think that fetishisms would have to be rather extreme before they would be considered abnormal.  If someone has a fetish to the point where they have to steal items for their collection or if there is no other way to arouse this person then I would consider this an abnormality. 

It is very hard to draw the line when it comes to sexual preferences.  Since exhibitionism, voyeurism, frotteurism, and pedophilia all involved sexual activity or viewing without the other person’s consent I would categorize them as abnormal behaviors due to the deviant aspect.  Sexual masochism is a rather difficult one because it isn’t necessarily a threat to others.  However, it may have a negative affect on a person who is in a relationship with someone who enjoys sexual masochism in that they may be expected to cause their partner to suffer against their will.  Extreme cases may cause permanent damage to the person receiving the suffering, which may cross the line into abnormality.  Sexual sadism may not be abnormal as long as the person who engages in it has full permission from the other person partaking and the harm inflicted is minimized to such things as blindfolding, restraining, etc.  However, when this behavior involves raping, killing, and mutilating then I would consider this psychologically abnormal.

Schizophrenia and Abnormality

I would generally say that someone who has schizophrenia would fall under the label of “abnormal psychology.”  However, having symptoms of schizophrenia doesn’t necessarily make someone a schizophrenic.  For instance, someone who seems to have delusions of grandeur may be merely misguided and not necessarily suffering from schizophrenia.  Some people may believe they are the reincarnation of some great king, or they feel they are called by God to perform miracles at some point in the future.  Some may claim to hear from God or other spirits but upon closer examination they aren’t hearing distinct audible voices as one who suffers from schizophrenia would.  However, one who is suffering from legitimate hallucinations, illogical and bizarre thinking, and other symptoms to the point where they cannot properly function I would consider psychologically abnormal. 

Personality Disorder and Abnormalities

Personality disorders are a bit tricky because anyone reading the chapter may be able to somewhat put himself or herself in one or more category.  However, at the beginning of the chapter it states that people with these disorders usually don’t have the flexibility to interact appropriately with our surroundings (Comer 2008).  While this might not define the abnormal side of personality disorders it gives us a hint of what to look for.  It would seem to me that certain criteria would have to be in place to distinguish whether a personality disorder would be considered abnormal.  I would think that the amount of symptoms and the degree at which these symptoms show themselves would be a good place to start.  While 5 out of 9 symptoms are needed to identify borderline personality disorder, the degree to which these symptoms persist need to be looked at.  Someone could seem to have 5 of these symptoms, yet none of them may be to the degree that this person can be validly diagnosed with BPD. 

Paranoid personality disorder I would consider abnormal if it had a strong negative affect in someone’s life.  I knew a guy who was homeless so he would ask people if he could stay with them.  After not too long, he would start accusing those he lived with as setting up spy cameras to watch him.  He would believe that they were somehow connected with the police and were putting spy bugs in his shoes.  He was extremely distrustful and whenever he lost a job he thought that he was somehow being plotted against.  I would consider paranoia to this degree to be abnormal.  Schizoid personality disorder is hard to label as ‘abnormal” due to the fact that these people seem to be able to function in life as long as it involves little contact.  The main problem I see with this is if they get married and have a family.  In this case they may need to learn to properly interact with their spouse and children.  However, schizotypal personality disorder I would consider abnormal due to the fact that it can cause one to show inappropriate emotions (Comer 2008).  Also their lives may become unproductive due to this problem (Skodol et al as sited in Comer 2008).

Antisocial personality disorder I would consider abnormal because a person with this disorder is known to violate the rights of others (APA 2000 as sited by Comer 2008).  Out of the personality disorders this one seems to be the most disruptive to one’s life and the life’s of those around him or her.  They tend to have trouble with criminal behavior, lying, keeping a job, spending money, a disregard for safety for themselves and others, etc. (Comer 2008).  This seems to me that it would be a very difficult disorder to treat.  One properly diagnosed with borderline personality disorder I would consider to be psychologically abnormal.  Someone with this disorder would have a difficult time in living a high quality life and are often a danger to themselves.  They may cause worry and concern for those close to them with their self-harm and suicide threats (Comer 2008).  While these people may seek relationships to counter the feelings of emptiness, these relationships are often unstable and can be difficult for both people involved.  I would consider histrionic personality disorder abnormal due to its affect on the person with the disorder and those in a relationship with him or her.  They seem to go to extremes to get attention and may even use threats of suicide to manipulate others (Lambert; APA as sited by Comer 2008).  This would cause people with this disorder to have a difficult time in keeping friends or functioning in relationships.  While I would consider narcissistic personality disorder to possibly be the least “abnormal” out of the “dramatic” personality disorders, it would still cause problems when it came to relationships.  For the most part, having friends and family requires a certain amount of empathy that a person with this disorder may have a hard time giving.  That many with this disorder come across as arrogant may also have an unhealthy affect on relationships (Comer 2008). 

I would consider avoidant personality disorder as being abnormal.  It is different from schizoid personality disorder in that people with this disorder are fearful of rejection or negative evaluation (Comer 2008).  This could lead to a low quality of life in that the person may struggle with anxiety in social situations and depression due to the perception of being rejected.  They seem to desire healthy friendships and relationships but too afraid to attempt at establishing any.  Dependent personality disorder I would consider abnormal because it is often burdensome for those that this person depends on.  Due to their fear of relationships ending they may allow themselves to suffer abusive partners (Comer 2008).  Both the quality of their life and the lives of those around them can be heavily affected by this disorder.  Obsessive-compulsive disorder in the more extreme cases I would consider abnormal.  The lack of satisfaction and high self-demands may lower the quality of life.  Jobs that require high production rates may be difficult for those who struggle with this disorder (Comer 2008).  However, a job that focuses on quality rather than quantity may be good for such an individual. 

Childhood Disorders and Abnormalities

With most of the childhood disorders I would consider them abnormal if they hit a certain criteria.  While it is normal at times for a child to be argumentative and throw temper tantrums I would say that a child who constantly demonstrates this behavior might be diagnosed with oppositional defiant disorder or in worse cases conduct disorder (Comer 2008).  I do believe that attention deficit/hyperactivity disorder is abnormal in that it creates a difficulty for the child to learn and perform tasks that require instruction.  It also is a disorder that may distract other children who are trying to learn since those with ADHD can often become a distraction to the class and may end up drawing unwanted attention to themselves.  Misbehavior is evident in most children with ADHD (Stevens & Ward-Estes as cited in Comer 2008).  I have heard people say that there is no such thing as ADHD but I have to strongly disagree with that position.  Elimination disorders would fall under the category of abnormal if they persist well beyond the normal ages for being fully potty trained with the exception being that the child didn’t have parents who gave any guidance to training the child.  I wouldn’t consider this a severe abnormality since these problems usually fade rather quickly especially if behavioral therapy is provided (Nield & Kamet as cited by Comer 2008).  Autism, asperger’s syndrome, and mental retardation would probably fall under the category of being psychological abnormal because it is usually difficult for them not to struggle their way through life without some assistance and guidance. 

When it comes to the elderly, I’m not sure if I could consider these disorders to be abnormal.  It is normal to have a degree of trouble as one ages.  They may become more susceptible to anxiety and depression as they age being that they can’t function like they once did and maybe they look back on their life and feel as if they didn’t accomplish what they wanted.  I do believe that elderly people who struggle with these issues may need therapeutic methods to help them through these obstacles so they can live out the rest of their lives with happiness and to be in as good health as possible.  Interestingly, it seems more abnormal for the elderly to engaged in substance abuse since this usually declines with old age (Aldwin; Oslin & Holden as cited in Comer 2008).  Unfortunately some elderly people may not admit to substance abuse and therefore not be able to seek the proper treatment.  I would not consider most cases of dementia in an aging person as being abnormal because it is natural that as we get older our brains may not function to the same extent, however, that does not mean that psychologists shouldn’t do what is necessary to slow down the process or help out where they can. 

One disorder that I would consider to be psychologically abnormal yet isn’t mentioned in the textbook is misophonia also known as selective sound sensitivity syndrome (4S).  4S has to do with being extremely sensitive to certain noises that can annoy and frustrate the person listening to them.  People with 4S are often sensitive to oral sounds such as chewing, tooth brushing, coughing, and other sounds such as tapping, typing, etc.  This syndrome can affect the quality of life in that one with 4S may avoid social situations in order to avoid the noises they deem as unpleasant (wikipedia). 

As I get done with the disorders and discussing how I believe the abnormal and normal aspects should be distinguished I feel it is important to discuss the issue of “labeling.”  Sometimes people are quick to label others and put them in a certain category.  When it comes to psychology, labeling someone too quickly can be rather risky.  Perhaps a counselor is meeting someone for the first time and tells the person that they are suffering from major depression.  This could, first of all, create a self-fulfilling prophecy being that the client may become more depressed because they believe that they are already suffering from depression.  Next thing you know, the person may go out and tell others that they have been diagnosed with depression which may cause others to look at this person differently.  Some clients may use their labels as excuses for their behavior.  Perhaps a teenager has been told that they suffer from attention deficit/hyperactivity disorder and instead of genuinely trying to do well on his homework, he uses his disorder as an excuse not to try.  On the flip side of the coin, perhaps a client has been properly diagnosed with a disorder and the best way to do this is to understand the disorder and to work with the client on bettering the symptoms caused by the disorder.  Let’s use posttraumatic stress as an example.  To deal with PTSD a counselor will likely have to tell her client of the diagnosis so she can work with the client on conquering PTSD. 

There are different angles to look at when it comes to using these disorders in legal settings and dismissing behavior because of these disorders.  It is very important for society to be protected from people who demonstrate dangerous behavior.  When a murder, rape, or another extreme crime has been committed I do not believe that the person’s behavior should be easily dismissed.  I do believe that people who have committed such crimes should be allowed to work with psychologists to learn to modify their behaviors and may be allowed to get out on parole. 

Another problem would be people using the excuse of “temporary insanity” to try to manipulate the system on not being so harsh on them.  This is why a good amount of testing and analyzing should be done on one who pleads “not guilty by reason of insanity” before a verdict is reached.  Fortunately this plea is a rarity (1%) and most do not fake their symptoms (Steadman et al. as sited in Comer 2008).  It seems to me that today we have a pretty good system in place when it comes to mental health and the law.

Upon completing this paper, I have come to understand the difficulty of discerning what would fall under the category of “abnormal psychology.” Since every individual is different and those with disorders will have a different degree of the disorder or react differently to it, it seems that there is a large gray area between what is normal and abnormal.  I do believe that even a well-trained and educated psychologist would have a degree of difficulty in determining abnormalities in certain individuals.  I have also gained an understanding of the difficulty in accurately using the law to determine whether someone falls under the banner of “not guilty by reasons of insanity.”  While we can make educated judgments considering these issues, there seems to be very few absolute answers.  


Bibliography

Website

Wikipedia - http://en.wikipedia.org/wiki/Selective_Sound_Sensitivity