Abnormality is a derivative concept, since it depends on an understanding of normality. Moreover, normality describes norms of behaviour but does not prescribe what is necessarily healthy or adaptive. Models of abnormality have changed over time, from ascribing spiritual causes to disorders, to viewing abnormality as erroneous behaviour, to finally understanding abnormality as involving disorders. Abnormality can be defined and understood in statistical, cultural, and psychological terms.
Today several models are used to explain and treat abnormal functioning. At one end of the spectrum is the biological model, which sees physical processes as the key to human behavior. At the other end is the sociocultural model, which examines the effects of society and culture on individual behavior. In between are four models that focus on more psychological and personal aspects of human functioning: the psychodynamic model looks at people’s unconscious internal events and conflicts; the behavioral model emphasizes behavior and the ways in which it is learned; the cognitive model concentrates on the thinking that underlies behavior; and the humanistic-existential model stresses the role of values and choices in human functioning.
Given their different assumptions and concepts, the models are sometimes in conflict. Those who follow one perspective often scoff at the “naive” interpretations, investigations, and treatment efforts of the others. Yet none of the models is complete in itself. Each focuses mainly on one aspect of human functioning, and none can explain all aspects of abnormality.
1. The Spiritual Model
Archaeological and archival evidence indicates that abnormal behaviour has been identified throughout human history. Originally abnormal behaivour was ascribed to spiritual sources, and its treatment was related to religious practices and concepts. Thus disorders might be labeled as demonic possession and their victims beaten, ostracized, exorcized or executed.
It is believed that many of the men and women charged with and executed for witchcraft during the Middle Ages were suffering from various psychological disorders. The spiritual "model" of abnormal behaviour provided social and legal rules but no understanding of its causes or treatments.
2. The Moral Model
A moral model of abnormal of behaviour emerged gradually from the 16th century onward in Western Europe. Physical treatments were attempted (eg. bloodletting to release "bad humours"), but those with psychological disorders were segregated from those with physical disorders. A difference between the two was perceived, although no therapeutic models had yet been developed. Beginning with the work of French physician Philippe Pinel in the late 18th century and continued by American teacher and social activist Dorothea Dix in the 19th century, the moral model of abnormal behaviour advocated the view that the mentally ill needed compassion, kindness and pleasant surroundings.
3. The Medical Model
The medical model of abnormality was developed in the late 19th century with the growth of the medical specialty of psychiatry. In the medical model, disordered behaviour and thought are the symptoms or observable signs of diseases that affect the function of the nervous system. Cures and treatments are applied to the patients to alleviate their symptoms and eliminate the illness.
In the 20th century, with the development of psychotherapies independent of medical therapies, the medical model has given way to a more eclectic (varied) view of abnormality and its treatment. Nonetheless the medical model remains popular and influential today. An example of an application of the medical model can be observed when social problems like drug addiction and crime are referred to simplistically as "diseases".
4. Psychological Models
Psychological theories have led to different models of abnormal behaviour, each with its own assumptions about the causes and forms of abnormality. The psychoanalytic model explainus disordered behaviour in terms of unconscious conflicts. According to the behavioural model, abnormal behaviour is learned, just as normal behaviour is, through experiences of associations, reinforcements, and punishments. More recently, the cognitive model has argued that internal processes like expectations, biases, errors, and illusions in conscious thought result in maladjusted and disordered behaviour. Each of these models makes therapeutic recommendations on the basis of its own terms and assumptions.
5. Biological Model
This is the dominant model in our society today. This model defines abnormality as mental illness – "sick in the head" – the brain is not working in the way that it should. Mental illness can be treated in hospital with drugs and surgery. The symptoms are looked at and then an attempt at cure is made with prescriptions.
Mental illness does not show up in blood tests or x-rays, there are no bodily symptoms, it is "all in the head". There are no physical tests, which poses problems for doctors. They can only classify, diagnose and treat according to the symptoms presented.
- A neurotic is somebody who has a problem that they are aware of: "I am depressed", "I'm having strange thoughts", "I have a phobia" etc.
- A psychotic is not aware of their abnormality or illness. It may take over and the sufferer becomes detached from the world around them, as in Schizophrenia. There are two types of psychosis, Organic and Functional
- Functional psychosis is where there appears to be no physical reason, but the person is functioning in a different way, loses contact with the world.
- A mentally retarded person has "the mind of the young", and this may be caused by anything: accident, illness, etc.
6. Psychodynamic Model
The psychodynamic model is the oldest and most famous of the modern psychological models. This approach believes that something happened in the past that the person is unable to deal with, and this causes the problems in the present. The memory is buried, or repressed, and has gone into the unconscious mind.
Psychodynamic theorists believe that a person’s behavior, whether normal or abnormal, is determined largely by underlying psychological forces of which he or she is not consciously aware. These internal forces are described as dynamic- that is, they interact with one another; and their interaction gives rise to behavior, thoughts, and emotions. Abnormal symptoms are viewed as the results of conflicts between these forces. Psychodynamic theorists believe that these conflicts are tied to early relationships and to traumatic experiences that occurred during childhood. Psychodynamic theories rest on the deterministic assumption that no symptom or behavior is “accidental”: all behavior is determined by past experiences.
The psychodynamic model was first formulated by the Viennese neurologist Sigmund Freud at the turn of the twentieth century. After studying hypnosis, Freud developed the theory of psychoanalysis to explain both normal and abnormal psychological functioning, and a corresponding method of treatment, a conversational approach also called psychoanalysis.
According to Freud, the Unconscious mind is 2/3 of the total mind, the conscious being 1/3. The preconscious is the small part between the two. The purpose of Psychodynamic therapy is to make the unconscious conscious.
- Ego Defence Mechanisms: The Ego puts either the desires or rules into unconsciousness to make its job easier as it cannot satisfy both. Denial and Repression are examples of Ego Defence Mechanisms.
- Slips of the tongue – Freudian slips: Truth sneaks out when least expected – it has not passed through sensors / filters: come straight from the unconscious.
- Free Association: Flowing conversation – let it go wherever it goes. The idea is that the patient may make statements they did not intend to and the therapist picks these out of the conversation for analysis.
- Word Association: A list of unconnected words is read and the patient says the first word that comes into their mind. E.g. "milk" might illicit the response "drink". Here the therapist is looking for "odd" associations, e.g. "father" might illicit the response "punishment".
- Dream Analysis: Patients keep a diary, and the therapist looks for hidden meanings or things that might be symbolic of what is happening in the unconsciousness. The diary is interpreted in the light of what is known of the patient by the therapist.
All these approaches are effective, but only to a very small degree.
- Projective Testing: The theory is that we project our own inner feelings onto other people and things. A good example is the famous inkblot tests. These contain no picture or hidden meaning, but Freud thought people would project their own feelings, and looked for a developing pattern when a patient was shown many of these drawings.
- Regression: This is where the patient is asked to re-live parts of their life and examine them in detail, including their thoughts and feelings both at the time, and now.
The behavioral model concentrates on behaviors, the responses an organism makes to its environment, which can be either internal or external. In the behavioral view, people are the sum of their learned behaviors. Therefore, behavior theorists base their explanations and treatments on principles of learning, the processes by which these behaviors change in response to the environment. The behavioral model began in laboratories where psychologists were running experiments on conditioning, simple forms of learning.
8. Humanistic-Existential Model
As humans we have the ability to pursue philosophical goals such as self-awareness, strong values, a sense of meaning in life, and freedom of choice. Humanists, the optimists of the two groups, believe that human beings are born with a tendency to be friendly, cooperative, and constructive. People, these theorists propose, are driven to self-actualize- that is, to fulfill this potential of goodness and growth. They can do so, however, only if they honestly recognize and accept their weaknesses as well as their strengths and establish satisfying personal values to live by. Existentialists agree that human beings must have an accurate awareness of themselves and live meaningful, authentic, lives in order to be psychologically well adjusted. But existentialists do not believe that people are naturally inclined to live positively, instead they believe that from birth we have total freedom, either to face up to our existence and give meaning to our lives or shrink from that responsibility.
9. Sociocultural Model
According to the sociocultural model, abnormal behavior is best understood in light of the social and cultural forces that influence an individual. What are the norms of society? What roles does a person play in the social environment? What kind of family structure is the person part of? And how do other people view ad react to him or her? The model borrows concepts and principles from two fields: sociology, the study of human relationships and social groups, and anthropology, the study of human cultures and institutions.
10. Cognitive Model
In the early 1960s, Albert Ellis and Aaron Beck proposed that cognitive processes are at the center of behavior, thought, and emotions and that we can best understand abnormal functioning by looking to cognition. How do cognitive theories explain abnormal functioning? Some people may make assumptions and adopt attitudes that are disturbing and inaccurate. Illogical thinking processes are another source of abnormal functioning, according to cognitive theorists. Beck has found that some people consistently think in illogical ways and keep arriving at self-defeating conclusions. He has also identified a number of illogical thought processes regularly found in depression, such as overgeneralization.
Labels: Psychology of Abnormality