Shrink's Views

ramblings of an unknown psychiatrist

“Normal”, “Abnormal” and “Label”

Posted by Dheeraj Kattula on June 26, 2009

Warning:

The post might have a lot of jargon,which you might not enjoy. It might be written in a fashion, which may make you feel that author and his thinking is complicated. Don’t worry. He is ‘normal’ only. If you want to stop reading the post mid-way, It might be absolutely ‘normal’. So, no problems with that too. If you call this post bad, I would say you are a ‘label-er’ but not ‘abnormal’. If you say this is written splendidly in Sanskrit, it is only then I could consider you abnormal. Assuming normalcy of some sort I invite you to read the post:

“Normal”, “Abnormal” and “Label”

There would always be debates on defining, what is ‘normal’. There are many models to define what is abnormal.

‘Statistical infrequency’ is one of the models to define what is abnormal. If some thing is rare then it is abnormal. If that be the case gifted people are abnormal as they are rare!

‘Failure to function adequately’ is another model to help not labeling gifted individuals as abnormal. But, who defines what is adequate and what is functioning? Is there a consensus?

‘Deviation from social norms’ is another such model. Social norms vary with culture, context, situation, age, gender, development and historical context (time).

Identifying parameters that are abnormal, considering the possible causes and treating them is a part of routine medical practice. In psychiatry, the parameters are more behavioral in nature.

Is “normal” a dichotomous construct (yes/no), a continuous construct (0-fully dysfunctional, 100-Mahatma Gandhi), or a dimensional construct (Einstein- professionally a genius, politically eccentric, interpersonally deficient)?

If we observe, we might find ourselves in different areas of the normal curve in different aspects. For example when I dance (as I sometimes do), people don’t see me in awe but rather laugh in amusement :-/ ( not so sadly :-)) Dancing Dheeraj

Or when I play cricket, I know the timing of my shots is awful. I might discuss the physics behind ‘reverse swing’ but would never be able to read its trajectory and time a ‘square-cut’ to the boundary. This just shows that I probably am low in Body Kinesthetic Intelligence. A not so sophisticated ‘labeler’ might call me ‘Kinesthetically Retarded’! (Ops! I labeled him a ‘labeler’ :-)) .The more specialized psychiatrists have even a diagnosis for it ‘Developmental Coordination Disorder’. “Diagnoses for all by 2025” seems to be the motto of some psychiatrists.

It is interesting that though we draw clear lines and cut across the parameters as normal and abnormal, most parameters are distributed normally. There are individuals very close to the line drawn but on different sides of it. They end up with different labels/ diagnosis and probably different treatments. Is this not quite terrifying?

Not just that, if the line is drawn somewhere close to the mean, then we have more problems. Take for example Complicated grief, Atypical PTSD (Post Traumatic Stress Disorder), High-functioning Asperger’s syndrome, Developmental Coordination Disorder etc. Besides, some conditions that are abnormal in a majority of settings become desirable in very narrow contexts. For example Anti-Social Personality Disorder in politicians and businessmen, Histrionic Personality in actresses and performers, Schizoid Personality in mathematicians and physicists and so on.

Good news is that most medical researchers consider these statistical issues before formulating guidelines and are not keen on labeling everything and everyone as abnormal. Most Clinicians go by patterns of symptoms, signs, laboratory results and diagnostics not isolated laboratory findings. Clinicians are not bothered, so thankfully not confused about statistical issues!

A good doctor picks up most of the abnormal parameters in his history taking, clinical examination and diagnostic work up, logically thinks through and explains these with the most judicious explanation, considers rarer possibilities and tries to rule them out or in and treats appropriately covering for most possible causes and always tries to relieve symptoms and is less bothered about the ‘label’ he gives to his patients.

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4 Responses to ““Normal”, “Abnormal” and “Label””

  1. Apparently for some, therapeutic treatment is indicated for ‘hyperlexia’. What I’ve learned from this curiously purple-and-blue tinted text is that learning is abnormal and being liked by rednecks is the ultimate goal in life. By the way, tava lekhyaṃ bhāsura asti. (Forgive me. My Sanskrit’s rusty. And may the force be with you. Lol!)

    • Dheeraj Kattula said

      Thanks Glen for visiting my blog and bothering to comment.I am thrilled to find you have linked my blog to yours.Thanks.

      I have studied Sanskrit for 5 years.I must say that your Sanskrit is not bad at all.A lot of people mug up (as I did) the cases and do not really know the meaning.For eg when you say ‘tava’ in Sanskrit it means ‘your’,but all that many students manage to learn is that the word has something to do with the word ‘tvam’ meaning ‘you’.I have purchased a book ‘Teach Yourself Sanskrit’written by Michael Coulson to brush up my knowledge.

      I am able to appreciate linguistics.I suppose you are deeply into it.I wish you all the very best in finding common relationship between Etruscan, Lemnian, Rhaetic, Eteo-Cypriot, Eteo-Cretan and Minoan and any other stuff 🙂

      I ll try to read that book link that you have given about how the gifted brain works.Do come back to the blog sometime 🙂

  2. Bok Leho said

    You made some excellent points here. I did a search on this and most people agree with what your saying. Will you be updating this blog in the future? I bookmarked you and will check back later. Thanks for the info.

    • Dheeraj Kattula said

      Thanks Bok Leho for visiting the blog and taking time to comment.
      I have been busy lately and therefore I have not been posting in recent times.
      I hope to post interesting stuff in the future. Thanks once again. 🙂

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