What is Normal?
The Times' "Stone" series has an essay by Gary Gutting (Notre Dame) on psychiatry's upcoming revisions to the "Diagnostic and Statistical Manual of Mental Disorders" and what it says not about mental disorders, but about psychiatry. From the essay,
Foucault is, then, right: psychiatric practice makes essential use of moral (and other evaluative) judgments. Why is this dangerous? Because, first of all, psychiatrists as such have no special knowledge about how people should live. They can, from their clinical experience, give us crucial information about the likely psychological consequences of living in various ways (for sexual pleasure, for one’s children, for a political cause). But they have no special insight into what sorts of consequences make for a good human life. It is, therefore, dangerous to make them privileged judges of what syndromes should be labeled “mental illnesses.”
This is especially so because, like most professionals, psychiatrists are more than ready to think that just about everyone needs their services. (As the psychologist Abraham Maslow said, “If all you have is a hammer, everything looks like a nail”). Another factor is the pressure the pharmaceutical industry puts on psychiatrists to expand the use of psychotropic drugs. The result has been the often criticized “medicalization” of what had previously been accepted as normal behavior—for example, shyness, little boys unable to sit still in school, and milder forms of anxiety.
1 comment
The problem of normality
Submitted by Steven H on Mon, 02/11/2013 - 18:36.The problem of normality definitely taints how we understand mental health care. For just as the very anthropologists who study other cultures belong, themselves, to some particular culture (and so run the risk of ethnocentrism due to implicit cultural prejudices), mental health care professionals themselves run the risk of acting on certain implicit social/moral prejudices when determining what is or is not a mental illness. So it's definitely a fundamental problem in health care.
Although, there's clearly certain mental conditions that are problematic just in terms of general functionality (and so have little to do with social/moral judgments). Moreover, as someone said in response to the article, some people opt for medication simply due to their own personal standards of functionality, regardless of what society/psychiatrists deem normal or abnormal. So it's not entirely accurate to say that mental health care professionals are simply running around looking for problems people don't actually have (even if this likely happens in certain instances).
Lastly, just as psychiatrists run the risk of thinking unsual, albeit benign behavior is a sign of mental illness, they also run the risk of assuming behavior which seems normal is definitely not a form of mental illness. Thus, we often think of shyness as a normal, harmless part of life we all experience at one point or another. However, as psychologists have in recent decades realized, a small portion of the population actually experiences an extreme form of shyness that is, to some extent, debilitating (and therefore, not normal). So, there may just be good reasons for using medication to treat certain forms of anxiety, despite the fact that we *assume* they are just a normal part of life. But even so, some have argued that treating children who move around too much is nothing more than medicating normal behavior, and I might agree with that particular point.
Ultimately, Foucault is definitely spot-on, as how we determine normal from abnormal mental conditions can be influenced by our very own social and moral prejudices. But I'm not so sure about Professor Gutting's particular claims. Nice article.