Defining the abnormal in psychiatric practice is one of the most provocative endeavours. The topic has been always regarded as a challenge and the pros and the cons have been thoroughly examined over the years. In the recent years the dilemma has been more hotly debated because of the proposed changes of criteria in the new Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
How do ordinary people perceive the difference between normal and abnormal feelings and behavior? It has been suggested that the human mind forms concepts and stereotypes based on its theories about the world and “the concept of mental disorder cannot be distinguished from beliefs about etiology and symptoms”( Kirmayer at all,1994). Consequently, normal and abnormal is a concept based cultural practices, social acceptance, moral judgment and normative expectations. According to Ahn, Novick and Kim (2003), the key mechanism underlying the judgment of abnormality is understanding. Behaviour may be judged to be abnormal because it is difficult to understand, infrequent, or categorically distinct from normal behaviour, and these three judgments are psychologically distinct (Ban et all). However, it is unclear how such public views affect attitudes towards people with mental illness and reactions to one’s own potential mental illness .The concept of abnormality appears to differ cross-culturally and people from different cultural backgrounds judge the normal in accordance to their particular norms. As a consequence, the majority may become intolerant and stigma may then be affixed to a person or group of persons, by the greater society, who differs from their cultural norms. It is very interesting the example given by the author regarding the cultural differences between the concept of depression in English-speaking cultures, with all his historical connotations and the term of depression in Japan, where the term used for that severe form of depression (utsubyo)could not be applied to the lower level feelings of distress and suffering that are now labelled depression in our society(Watters,2010)
On the other hand, society’s expectation is that doctors are trained to find clear diagnosis based on well established biological and pathological explanations then to give the right solution, ideally interventions without complications or medications without any side effects. Medical professionals are trained to practice the "medical model", and therefore to classify illnesses into physical and mental/psychological. Although we might not fully understand yet, we do realize that psychological processes influence physical illnesses and vice versa.
Behavioral distress often gets classified into a psychiatric disorder without adequate reasons. Nancy Adreasen, a psychiatry professor and one of the most influential scientists in the USA, in her book "The Broken Brain", observed that the question "What is mental illness" is extremely complex and, indeed, difficult to answer.
It is important for psychiatrists to admit , when circumstances requires, that they don’t know certain things and they are often limited in so many ways, starting with the process of diagnosis itself , continuing with the theoretical explanations and finishing with the intimate resorts of the psychopharmacology and rehabilitation. In this respect it is important to note that, in order to understand we have to look outside the bio-medical model and always attempt to reach beyond the brain into the social, cultural and psychological dimensions.
It has been widely recognized that all forms of suffering involve intricate relationships between genetic predispositions, personal development and significant events embedded in cultural and social systems. Therefore, we will always need to use the fundamental knowledge about the brain in the endeavour to find organic causes of mental disturbance and the deep understanding of…