Normality (behavior)

In his Rules of the Sociological Method, French sociologist Émile Durkheim indicates that it is necessary for the sociological method to offer parameters in order to distinguish normality from pathology or abnormality. He suggests that behaviors, or social facts, which are present in the majority of cases are normal, and exceptions to that behavior indicate pathology.[6] Durkheim's model of normality further explains that the most frequent or general behaviors, and thus the most normal behaviors, will persist through transition periods in society.

Crime, for instance, should be considered normal because it exists in every society through every time period.[7] There is a two-fold version of normality; behaviors considered normal on a societal level may still be considered pathological on an individual level. On the individual level, people who violate social norms, such as criminals, will invite a punishment from others in the society.

An individual's behaviors are guided by what they perceive to be society's expectations and their peers' norms. People measure the appropriateness of their actions by how far away they are from those social norms. However, what is perceived as the norm may or may not actually be the most common behavior. In some cases of pluralistic ignorance, most people wrongly believe the social norm is one thing, but in fact very few people hold that view.

When people are made more aware of a social norm, particularly a descriptive norm (i.e., a norm describing what is done), their behavior changes to become closer to that norm. The power of these norms can be harnessed by social norms marketing, where the social norm is advertised to people in an attempt to stop extreme behavior, such as binge drinking. However, people at the other extreme (very little alcohol consumption) are equally likely to change their behavior to become closer to the norm, in this case by increasing alcohol consumption.

Instead of using descriptive norms, more effective social norms marketing may use injunctive norms which, instead of describing the most common behavior, outline what is approved or disapproved of by society. When individuals become aware of the injunctive norm, only the extremes will change their behavior (by decreasing alcohol consumption) without the boomerang effect of under-indulgers increasing their drinking.[8]

The social norms that guide people are not always normal for everyone. Behaviors that are abnormal for most people may be considered normal for a subgroup or subculture. For example, normal college student behavior may be to party and drink alcohol, but for a subculture of religious students, normal behavior may be to go to church and pursue religious activities. Subcultures may actively reject "normal" behavior, instead replacing society norms with their own.[9]

What is viewed as normal can change dependent on both timeframe and environment. Normality can be viewed as "an endless process of man's self-creation and his reshaping of the world."[10] Within this idea, it is possible to surmise that normality is not an all-encompassing term, but simply a relative term based around a current trend in time. With statistics, this is likened to the thought that if the data gathered provides a mean and standard deviation, over time these data that predict "normalness" start to predict or dictate it less and less since the social idea of normality is dynamic. This is shown in studies done on behavior in both psychology and sociology where behavior in mating rituals or religious rituals can change within a century in humans, showing that the "normal" way that these rituals are performed shifts and a new procedure becomes the normal one.

Since normality shifts in time and environment, the mean and standard deviation are only useful for describing normality from the environment from which they are collected.

As another example, understandings of what is normal sexual behavior varies greatly across time and place. In many countries, perceptions on sexuality are largely becoming more liberal, especially views on the normality of masturbation and homosexuality. Social understanding on normal sexual behavior also varies greatly country by country; countries can be divided into categories of how they approach sexual normality, as conservative, homosexual-permissive, or liberal.

The United States, Ireland, and Poland have more conservative social understanding of sexuality among university students, while Scandinavian students consider a wider variety of sexual acts as normal. Although some attempts have been made to define sexual acts as normal, abnormal, or indeterminate, these definitions are time-sensitive. Gayle Rubin's 1980s model of sexual 'normality' was comprehensive at the time but has since become outdated as society has liberalized.[11]

A disharmony exists between a virtual identity of the self and a real social identity, whether it be in the form of a trait or attribute. If a person does not have this disharmony, then he or she is described as normal. A virtual identity can take many definitions, but in this case a virtual identity is the identity that persons mentally create that conforms to societal standards and norms, it may not represent how they actually are, but it represents what they believe is the typical "normal" person. A real social identity is the identity that persons actually have in their society or is perceived, by themselves or others, to have. If these two identities have differences between each other, there is said to be disharmony. Individuals may monitor and adapt their behavior in terms of others' expected perceptions of the individual, which is described by the social psychology theory of self-presentation.[12] In this sense, normality exists based on societal norms, and whether someone is normal is entirely up to how he or she views him- or herself in contrast to how society views him or her. While trying to define and quantify normality is a good start, all definitions confront the problem of whether we are even describing an idea that even exists since there are so many different ways of viewing the concept.[13]

When people do not conform to the normal standard, they are often labelled as sick, disabled, abnormal, or unusual, which can lead to marginalization or stigmatization. Most people want to be normal and strive to be perceived as such, so that they can relate to society at large. Without having things in common with the general population, people may feel isolated among society.[14] The abnormal person feels like they have less in common with the normal population, and others have difficulty relating to things that they have not experienced themselves. Additionally, abnormality may make others uncomfortable, further separating the abnormally labelled individual.

Since being normal is generally considered an ideal, there is often pressure from external sources to conform to normality, as well as pressure from people's intrinsic desire to feel included. For example, families and the medical community will try to help disabled people live a normal life. However, the pressure to appear normal, while actually having some deviation, creates a conflict—sometimes someone will appear normal, while actually experiencing the world differently or struggling. When abnormality makes society feel uncomfortable, it is the exceptional person themselves who will laugh it off to relieve social tension. A disabled person is given normal freedoms, but may not be able to show negative emotions. Lastly, society's rejection of deviance and the pressure to normalize may cause shame in some individuals. Abnormalities may not be included in an individual's sense of identity, especially if they are unwelcome abnormalities.

When an individual's abnormality is labelled as a pathology, it is possible for that person to take on both elements of the sick role or the stigmatization that follows some illnesses. Mental illness, in particular, is largely misunderstood by the population and often overwhelms others' impression of the patient.

Normality, as a relative concept, is intrinsically involved with contextual elements. As a result, clinical disorder classification has particular challenges in discretely diagnosing 'normal' constitutions from true disorders. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the psychiatric profession's official classification manual of mental disorders since its first published version (DSM-I) by the American Psychological Association in 1952.

As the DSM evolved into its current version (DSM-V) in late 2013, there have been numerous conflicts in proposed classification between mental illness and normal mentality. In his book Saving Normal, Dr. Allen Frances, who chaired the task force for content in the DSM-IV and DSM-IV-TR, wrote a scathing indictment of the pressures incumbent on the definition of "normal" relative to psychological constructs and mental illness.

Most of this difficulty stems from the DSM's ambiguity of natural contextual stressor reactions versus individual dysfunction. There are some key progressions along the DSM history that have attempted to integrate some aspects of normality into proper diagnosis classification. As a diagnostic manual for classification of abnormalities, all DSMs have been biased towards classifying symptoms as disorders by emphasizing symptomatic singularity. The result is an encompassing misdiagnosis of possible normal symptoms, appropriate as contextually derived.[24]

The second edition of the DSM could not be effectively applied because of its vague descriptive nature. Psychodynamic etiology was a strong theme in classifying mental illnesses. The applied definitions became idiosyncratic, stressing individual unconscious roots. This made applying the DSM unreliable across psychiatrists.[24] No distinction between abnormal to normal was established.

Evidence of the classification ambiguity were punctuated by the Rosenhan experiment of 1972. This experiment demonstrated that the methodology of psychiatric diagnosis could not effectively distinguish normal from disordered mentalities. DSM-II labelled 'excessive' behavioral and emotional response as an index of abnormal mental wellness to diagnose some particular disorders.[25] 'Excessiveness' of a reaction implied alternative normal behavior which would have to include a situational factor in evaluation. As an example, a year of intense grief from the death of a spouse may be a normal appropriate response. To have intense grief for twenty years would be indicative of a mental disorder. As well, to grieve intensely over the loss of a sock would also not be considered normal responsiveness and indicate a mental disorder. The consideration of proportionality to stimuli was a perceived strength in psychiatric diagnosis for the DSM-II.[24]

Another characteristic of the DSM-II systemization was that it classified homosexuality as a mental disorder. Thus, homosexuality was psychiatrically defined as a pathological deviation from "normal" sexual development. In the 7th printing of the DSM-II, "homosexuality" was replaced with "sexual orientation disturbance." The intent was to have a label that applied only to homosexual individuals who were bothered by their sexual orientation.[26] In this manner homosexuality would not be viewed as an atypical mental disorder; only if it was distressing would it be classified as a mental illness.[26][25] However, the DSM-II did not state that homosexuality was normal, either, and a diagnosis of distress related to one's sexual orientation was retained in all editions of the DSM until the DSM-5 in 2013, under different names.[27]

DSM-III was a best attempt to credit psychiatry as a scientific discipline from the opprobrium resulting from DSM-II.[22] A reduction in the psychodynamic etiologies of DSM-II spilled over into a reduction symptom etiology altogether. Thus, DSM-III was a specific set of definitions for mental illnesses, and entities more suited to diagnostic psychiatry, but which annexed response proportionality as a classification factor. The product was that all symptoms, whether normal proportional response or inappropriate pathological tendencies, could both be treated as potential signs of mental illness.[22]

DSM-IV explicitly distinguishes mental disorders and non-disordered conditions. A non-disordered condition results from, and is perpetuated by, social stressors. Included in DSM-IV's classification is that a mental disorder "must not be merely an expectable and culturally sanctioned response to a particular event, for example, the death of a loved one. Whatever its original cause, it must currently be considered a manifestation of a behavioral, psychological, or biological dysfunction in the individual" (American Psychiatric Association 2000:xxxi) This had supposedly injected normality consideration back into the DSM, from its removal from DSM-II. However, it has been speculated that DSM-IV still does not escape the problems DSM-III faced, where psychiatric diagnoses still include symptoms of expectable responses to stressful circumstances to be signs of disorders, along with symptoms that are individual dysfunctions.[24] The example set by DSM-III, for principally symptom-based disorder classification, has been integrated as the norm of mental diagnostic practice.[24]

The DSM-5 was released in the second half of 2013. It has significant differences from DSM IV-TR, including the removal of the multi-axial classifications and reconfiguring the Asperger's/autistic spectrum classifications.

Since the advent of DSM-III, the subsequent editions of the DSM have all included a heavy symptom based pathology diagnosis system. Although there have been some attempts to incorporate environmental factors into mental and behavioral diagnostics, many practitioners and scientists believe that the most recent DSM's are misused. The symptom bias makes diagnosing quick and easier allowing for practitioners to increase their clientele because symptoms can be easier to classify and deal with than dealing with life or event histories which have evoked what may be a temporary and normal mental state in reaction to a patients environmental circumstances.

The easy-to-use manual not only has increased the perceived need for more mental health care, stimulating funding for mental health care facilities, but also has had a global impact on marketing strategies. Many pharmaceutical commercial ads list symptoms such as fatigue, depression, or anxiety. However, such symptoms are not necessarily abnormal, and are appropriate responses to such occurrences as the loss of a loved one. The targets of such ads in such cases do not need medication and can naturally overcome their grief, but with such an advertising strategy pharmaceutical companies can greatly expand their marketing.[24]