Abnormal Vs. Normal Psychology
What is “abnormal?” What is “normal?” The term abnormal psychology once referred to psychological behavior that was “deviant,” that is, significantly different from the norm. Today, we hear very little about what is “deviant.”
Instead, abnormal psychology usually involves a disorder in which there is emotional distress (a painful symptom) plus dysfunction (impaired behavioral or psychological functioning). By emotional distress, we mean internal conflicts that produce intense and prolonged feelings of anxiety, insecurity, fear, or unhappiness. There are many categories of emotional distress that are not considered abnormal.
For example, it is not abnormal for a person to be depressed after the death of a loved one. Grief, though painful, is functional and enables a person to recover from the shock of loss. Grieving is what a person is supposed to do after a major loss.
Most psychologists and psychiatrists believe a person should not be considered abnormal simply because they exhibit behavior or thinking that is not “normal.” The individual may be unusual and behaviorally different from the norm without exhibiting dysfunctional behavior or thinking.
Deviance means not meeting the expectations of society. But what is normal in one society can be deviant in another, a fact Christians should understand. As we look at the Scriptures, we see many people who clearly deviated from the norms of their society, yet they were the most emotionally and mentally healthy people in their society.
The Old Testament prophets, the apostle Paul, and Jesus himself! They differed from the norm, but their thinking was functional, far more functional than the dysfunctional society in which they lived.
So, if deviance from the norms of society does not automatically define abnormal psychology, what does?
In truth, since we live in such a dysfunctional world, the more Christlike we become, the more abnormal we will be (in certain respects), the more functional our thinking will be, and the more effective our behavior will be in achieving God’s purpose.
There are several other ways to understand abnormality. For example, we view those who have severe emotional problems as being disordered or having a disorder. Note the semantic distinction between these two terms. The prevalent approach among psychologists today is to separate the disorder from the person, to say the disorder is something a person has.
For example, an individual is not an alcoholic; that individual has an alcohol dependency. Other professionals advocate individual choices and responsibility are key components of emotional healing and it does no service to the disordered person to suggest their abnormality is a “disease.” It's a cluster of symptoms affecting the spirit, mind, will, and emotions. They believe it is only valid to separate the individual from their disorder when a physical problem such as brain damage, or hormonal problems are at the base of that disorder.
Perhaps one of the best ways to understand what is abnormal and unhealthy is to draw a contrast between what good mental and emotional health is. A healthy person is able to function well intellectually, emotionally, physically, and spiritually. Healthy individuals can adapt to new situations, tolerate stress, and exercise self-control.
Healthy individuals are in touch with reality. They face life with a general attitude of confidence. They relate well to others, form friendships, give and accept love, and are able cooperate with legitimate authority.
Causes of Emotional Problems
Mental illness is usually caused by a number of factors, not just one. One or more of the following may be the cause:
Disease and other organic causes (perhaps the most obvious organic disorder with a mental/emotional component is Alzheimer’s disease).
Genetic background (heredity).
Environmental background (childhood issues).
Spiritual problems such as sin, religious addiction, and legalism.
Precipitating stress (recent or current issues).
Environmental influences that can lead to emotional disorders include such childhood hurts as:
Parental rejection and neglect
Physical or sexual abuse
Lack of discipline or overindulgence
Religious abuse (having been reared under the teaching and example that suggest God’s love is conditional and His judgment is harsh)
Excessively passive father and excessively dominant mother
Parents who were excessively demanding and perfectionists
Parents who were excessively protective
Having been raised in an atmosphere of continual conflict
These environmental factors indicate trends and statistical tendencies. That is, when we examine the background of emotionally troubled people, we tend to find a number of these factors. This is not to say people who have such factors are automatically fated to have emotional problems. Nor does this suggest people with such factors are excused for irresponsible or maladaptive behavior. Through therapy, support of caring family members and friends, individuals can learn to cope with these factors and can experience mental and emotional healing.
Genetic and environmental backgrounds are important factors in emotional problems, but it is crucial to remember they do not excuse present conduct. Regardless of the past, we are still responsible for making healthy choices today, and the words of the apostle Paul in Galatians 6:7 still hold true:
“Whatever a man sows, that he will also reap.”
A precipitating stress is an event or situation any person’s current life that contributes to a psychological problem. Examples of precipitating stress include marital difficulties, job stress, or financial problems.
When people go to a counselor or therapist for help, it is usually because of a precipitating stress they feel is unmanageable.
During counseling, they often uncover other issues besides the participating stress, issues that may be even more fundamental to the emotional problem but were hidden from their conscious awareness.
Many who think they are in control of their lives are actually being dominated by hidden emotions, conflicts, drives, and motives. They emphasize precipitating stresses as the sole source of their pain and life. “If only my spouse would change, my life would be great,” or “If only I had enough money, all my problems would be solved.”
It is the job of a psychologist or psychiatrist to look beyond those precipitating stresses and to help individuals discover issues hidden inside combined with precipitating stresses to create unhappiness and dysfunction.
Varieties of Emotional Disorders
Following are seven broad categories of emotional disorders. There are others besides these seven, but the ones we will discuss here are the most commonly observed forms:
Stress and adjustment disorders
The National Institute of Mental Health has estimated that 8 to 15% of the population has some form of anxiety disorder. Anxiety disorders include:
Phobias. Anxiety from past to present stress is focused on a specific object or situation. Phobic individuals avoid the specific objects or situations because of irrational fears.
Panic disorder. Anxiety is left unfocused and free-floating, so a person feels panic without knowing why.
Obsessive-compulsive disorder. Anxiety is displaced onto obsessive thinking, worry, and impulsive behavior.
Generalized anxiety disorder. The anxious individual demonstrates excessive talking, your debility, over-dependence, poor concentration, and lack of sleep.
Also called affective disorders, mood disorders are characterized by emotional extremes of either depression or relation. Examples of mood disorders include:
Manic depression. Also called bipolar disorder, because it involves swings from one emotional pole to the other, from depression to euphoria. In the manic or euphoric mode, the individual appears happy, energetic, nervous, talkative, enthusiastic, ambitious, and optimistic. He has a grandiose, inflated view of his own abilities and self-worth. In the depressed mode, he is sad, filled with painful thoughts, anxious, and delusional, and he feels little or no self-worth.
Guilt and despondency. The most dangerous aspects of manic depression is increased possibility of suicide, although the impaired judgment of manic depression can also lead to an individual to make serious mistakes in social settings, relationships, and financial commitments.
Cyclothymia. This disorder is similar to manic depression but is less severe. Whereas an individual with manic depression may oscillate fairly frequently between depressed and euphoric phases, the cyclothymic individual experiences much slower, longer cycles, perhaps remaining either euphoric or depressed for a period of months or years.
Major depression. This disorder affects more women than men and is most common among people in their 40s and 50s. Symptoms include moodiness, frequent crying, unkempt personal appearance, painful thinking, guilt, self blame, or anxiety.
There are other physical symptoms such as sleep and appetite disturbances, decreased sexual interest, headaches, and interrupted menstrual cycles. An extended form of major depression is called dysthymia.
In a psychotic disorder, the individual is in some way out of touch with reality. Examples of psychotic disorders include:
Schizophrenia. The four distinguishing features of schizophrenia are (1) flat, dull, or inappropriate mood, indicated by blank stare or by laughing or smiling while relating a sad story; (2) a tendency to ramble from one topic to another without logical association; (3) detachment, preoccupation, and absorption in a world of private fantasies (autism); and (4) severely reduced motivation and reduced ability to make choices (ambivalence). Schizophrenia may also be accompanied by delusions and hallucinations.
2. Delusional Disorder. This disorder is similar to schizophrenia in that the individual is out of touch with reality, may have a flat or inappropriate mood, and may be detached and self absorbed.
The delusional individual, unlike the schizophrenic, tends to have orderly ways of thinking. Their thinking is unrealistic and may even be paranoid, but one can carry on and follow a conversation with a delusional individual.
Stress and Adjustment Disorders
Stress and adjustment disorders are related to specific stresses. A post traumatic stress disorder is related to the intense stress of a traumatic event such as war, natural disaster, rape, car accident, or airplane crash. It is characterized by anxiety, recurrent nightmares, disturbed concentration, disturbed sleep, guilt, and depression. Adjustment disorders result when a person’s functioning is impaired because of an inability to cope with stress and change. Symptoms may include a depressed or anxious mood, withdrawal, hostile conduct, lack of motivation, and physical symptoms such as sleep and appetite disturbances, decreased sexual interest, and headaches.
These are recognized by changes in an individual’s consciousness or identity. Symptoms and forms of dissociative disorders include memory loss, sleepwalking, fugue (type of amnesia), multiple personality disorder, and depersonalization. Dissociative disorders are related to and triggered by events or situation an individual is unable to recall. They are so called because a person with such a disorder becomes disassociated from their identity.
An individual experiencing fugue may wander away from home and even establish a new identity as a totally different person, and will not even realize they have a new identity as a totally different person.
They will not even realize they have forgotten anything. When the individual returns to the normal state, they remember the past but forget everything that happened during the fugue state.
An individual with a multiple personality disorder is dominated by number of personalities, and they may change dramatically and suddenly from one personality to the next.
Sometimes one personality will have no knowledge of the others. In such cases, it is, for the primary personality to be very proper and moralistic; one of the secondary personalities is likely to be quite the opposite. A person experiencing depersonalization disorder experiences feelings of unreality and separation from self. Dissociative disorders are generally the result of disturbances in early emotional growth and development. The individual may repress sad or anxious feelings and memories in order to avoid painful emotions or difficult situations.
Somatoform disorders are physical disorders for which no medical cause can be found. Somatoform symptoms arise from displacement of emotional conflicts onto the body. Some disorders include:
Somatization disorder. (Briquet’s syndrome). This involves dramatic, vague, multiple complaints, often in various parts of the body, without any medical explanation. Sexual difficulties are often involved. This disorder is more common among women than men.
Conversion disorder. Emotional conflicts are represented as sensory or muscle control problems, such as loss of feeling, deafness, blindness, disturbances in skin sensation, pain paralysis of limbs, paralysis of vocal cords, involuntary twitches, or recurring peculiar movements. Symptoms may come and go in response to precipitating stress.
Somatoform pain disorder. Pain, without medical cause, is unconsciously used by the individual to avoid upsetting activity.
Hypochondriasis. The individual is preoccupied with bodily function or a fear of disease.
Body dysmorphic disorder. The individual is obsessively preoccupied with some imagined physical deformity.
Somatoform disorders should not be confused with fake disorders in which people, for whatever reason, consciously make up symptoms of illness.
Personality disorders are deeply ingrained patterns of negative, self-defeating behavior. In a truly disordered personality, these patterns are so firmly entrenched the affected individual is extremely resistant to treatment, and the personality disorder tends to be present throughout the individual’s life. The variety of emotional problems human beings are prone to is nothing short of astounding.