Beauty

Why Being Normal Isn't Always Healthy

Normalizing and Pathologizing in Psychology

Posted December 31, 2015

Western medicine is based on an allopathic paradigm that includes three fundamental assumptions. So is western psychology.

First, deviations from the norm are manifestations of an underlying pathology. Second, treatment should eliminate or reduce symptoms of the underlying pathology. And third, health is equivalent to restoration of the prior norm.

For example, when we don’t feel well we go to our doctor, who takes our temperature, orders blood tests, listens to our heart and lungs, and compares the resulting information to a norm based on thousands of other people. If our measurements fall within a certain range of that norm, we are considered normal, healthy. But if our measurements deviate too far from that norm we are deemed abnormal, unhealthy, and the doctor suggests treatment designed to bring our measurements back to normal and restore our health.

Mainstream psychology is also based on this allopathic paradigm. If people’s behavior or experiences are too far from the norm, they are considered deviant or “sick.” Subsequently, treatment is recommended to modify their behavior, normalizing them and making them healthy. I call diagnosing deviations from the norm as manifestations of an underlying pathology “allopathic thinking.”

Allopathic thinking pervades our lives; it governs the way we treat ourselves, our friends, family members, coworkers, and people we don’t know. For example, let’s say I am normally a diligent, hardworking person trying to complete my first book, but I am spending significant time surfing the Internet, watching television, and chatting with friends. These behaviors are outside my norm, and I begin thinking, “What’s wrong with me? Why aren’t I working on my manuscript?” My “inner therapist” says, “You have a procrastination problem; reduce distractions, focus, and you will again be your normal diligent, hardworking self.” If this doesn’t work, I might read some self-help books, meditate, or go to my therapist to help me return to my usual ways. However, my disturbing behaviors may, in fact, represent an intelligent resistance to the way I usually approach my writing, reflecting that I could use a break, am too perfectionistic, or need some fresh ideas and perspectives.

To use another example, suppose my wife, usually a warmhearted person and great listener, starts behaving in a distant or irritable manner. I automatically think, “What’s wrong with her? Isn’t she getting enough sleep? Is there too much stress in her life?” After trying to diagnose the problem, I recommend treatment that will restore her and our relationship to their usual state. However, her disturbing behavior may instead represent an intelligent resistance to her normally more accommodating style, perhaps reflecting the fact that she has some deeper needs that are not being addressed. Whenever a person’s behavior or experiences deviate from accepted norms, we employ the same paradigm, readily assuming something is wrong with them and making armchair diagnoses and treatment plans.

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Allopathic thinking is often fallacious for several reasons:

FALLACY 1: Just because people’s behavior differs from the norm does not mean something is wrong with them. Their odd behavior could be a sign of healthy change if the norm according to which they have lived is too restrictive or oppressive. Or their idiosyncratic behavior might be a sign of genius rather than pathology. In short, allopathic thinking can “make people sick” for expressing their individuality or growth potential.

FALLACY 2: We make determinations about other people’s behavior based on our personal norms. When people behave in ways that deviate from our personal norms, we are likely to attribute their disturbing behavior to a pathology, thinking of them as “sick” and in need of treatment. We do this without considering that our personal norms have more to do with our own comfort levels, culture, and biases than any underlying pathology; without understanding the behavior that made us uncomfortable; and without critical examination of our intolerance of diversity. In effect, we often “make people sick” simply because they make us uncomfortable.

FALLACY 3: We assume that people’s behavior is pathological based on the dominant culture’s norms. This fallacy leads to questionable assessments about whole groups of people whose behaviors differ from those of the dominant culture. There is perhaps no better example of this fallacy than when homosexuality became condemned not only in the sphere of religion and morality but also in psychology, turning what was considered a sin by the dominant culture into a pathology. While there was no scientific basis for regarding homosexuality as a disorder, homosexuals were nonetheless diagnosed as sick.

These and other forms of allopathic thinking result in labeling and treating “disturbing” people or groups as sick in order to relegate them to the margins of society, dismiss their concerns, constrain their development, or coerce them to feel and act in more acceptable ways. I learned to call this dynamic “pathologizing” people. (Thanks to Dr. Arnold Mindell for this terminology and understanding.)

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Our predisposition to restore a sense of normalcy as soon as possible when we feel disturbed or threatened by our own, or other’s behavior leads us to pathologize individuals compulsively, insulating us from listening to our/their needs and desires, seeing our/their beauty and intelligence, and heeding our/their wisdom. As a result, we attribute these disturbing qualities to pathologies and “treat” these qualities by trying to suppress them or fix them. This diminishes our/their value and functions as an insidious form of intolerance to diversity, whether expressed by an individual, group, or culture.

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