We need to start here with the fact that this word can have several different meanings. The same phenomena can be “normal” from one point of view and “abnormal” from another.
First, we can understand the norm statistically. Many psychological and psychophysiological characteristics are variable in a wide range, and the scatter of their values ​​can be described through the normal distribution. If we investigate some kind of intelligence (for example, by measuring the ability to solve typical problems from Eysenck’s tests), we will see a small number of extremely effective subjects, a small number of extremely inefficient and many intermediate, average results. We can consider these average results to be normative, and the regional results, respectively, to interpret as giftedness or, conversely, intellectual deficit. But here a reasonable question immediately arises: if the "bell" of the normal distribution has a smooth shape, then what gives us a basis for identifying qualitatively different areas in it? On what basis do we consider this or that value of the characteristic threshold, setting the limits of the norm? The answer is disappointing: we do not have this basis. The allocation of the normative area is a matter of agreement, and the decision on the limits of the norm here is made not on the basis of qualitative differences, but rather on the basis of psychological common sense. If from observations we know that for some fairly low values ​​of the parameter it becomes difficult for a person to function (for example, he cannot learn the school curriculum), then this allows us to say that such values ​​are abnormal. On the other hand, we can approach this issue formally, taking for example the top five percent of the results and the bottom five percent of the results that deviate. What can we say about a person who falls into these marginal zones? Only that it is exactly different in some separate parameter from most of the population. We don’t know whether this bothers him or not. We do not know if this creates problems for others. We only know that it is unusual.
The second option - we can understand the norm functionally. In this case, we just start by asking questions of a pragmatic plan. Is it convenient to live with such a feature, is it safe, does it interfere in some important aspects of life, does it worsen the quality of life? For example, Sigmund Freud once defined the psychic norm as the ability to love and work. What does this mean? This means that a mentally “normal” person can maintain a focused productive activity for long periods of time, and he can build stable close relationships that do not become painful and destructive. This is a convenient criterion because it is easy to track. If a person does not stay in any workplace for more than a few months, we understand that some problem prevents him from functioning. If all his relations break up within a few months (or cannot arise at all), we can also understand that there is some kind of problem. On the other hand, we can say that this particular person has a much narrower range of conditions in which he can function well, and in a certain way organized environment, he can be quite stable, constructive and productive, while retaining all the same features . For example, a deep introvert has a very small need for communication, and his relationship can systematically disintegrate due to the fact that his partners systematically feel deprived of attention. Does this mean that an introvert does not function well at all? No, this only means that he cannot maintain long-term close relationships with people who need a lot of communication and a lot of emotional feedback. However, it is possible that he may have a very stable and comfortable relationship with another deep introvert. Similarly, a certain type of people is not organically able to come to work on time, but it works very well in a free schedule. This is a situation when a person actually likes to work, but he has his own specific activity cycle. For example, it is completely unproductive early in the morning and very productive at three in the morning. We cannot say that this person is, in principle, an unfit employee; we can only say that he is good at the work that can be done at three in the morning, and not very good at the work that must be started at eight in the morning.
Accordingly, the third meaning that we can put in the concept of norm is related to the spectrum of typological options. For example, there may not be many green-eyed people in a population, but we do not consider green-eyed a problem, but consider it simply one of the possible options for pigmentation of the iris. In relation to activity cycles, we can distinguish the types of “larks” and “owls”, considering them to be simply individual variants. From this point of view, the need to work at three in the morning is just a feature of a certain type of people. For example, at some stage, homosexuality was extracted from the list of sexual disorders and began to be considered a typological option. The logic behind this is the following: a certain percentage of homosexual individuals spontaneously arise in a population, attempts to artificially change their orientation turn out to be completely futile, their orientation does not prevent them from working, maintaining relationships and being happy - which means, apparently, this should be considered as an individual feature. From the point of view of population reproduction, this feature, as we understand it, creates certain difficulties, but, firstly, not that humanity would be on the verge of extinction, and secondly, reproductive technologies have stepped far enough so that the appearance of offspring does not cease at all either depend on the sexual activity of the parents. If we proceed from the fact that the ultimate goal of applied psychology is to rid people of mental suffering, then, say, the normalization of sexual behavior options in the mass consciousness is more useful than trying to treat something that initially did not interfere with anything, because in this way we reduce the amount of suffering associated with stigma. The orientation itself does not cause suffering, but it makes them necessary to hide, lie about their relationships, experiencing their wrongness (pathological, sinful), insulting and evaluative remarks of others, etc.
The fourth meaning, respectively, is associated with the boundaries of the socially acceptable in a particular culture. In different communities, the same things can be considered normal, but can cause violent rejection. For example, in our culture, some chemical dependencies are normalized: dependence on nicotine and a slight degree of dependence on alcohol. It is known that these types of addiction have certain negative consequences for health (both of the dependent person himself and those around him), but at the community level there is an agreement that this is acceptable behavior, which is not a significant and serious problem. When we talk about the normal in the sense of social acceptability, we mean that a person with certain characteristics will probably not have problems in interacting with society associated with a negative reaction to these features. Such normality will naturally be a relative characteristic, depending on the particular community and its internal boundaries of acceptability. The use of physical and emotional violence against children, for example, in some cultures is normalized, while in others it is considered unacceptable. This does not mean that in some cultures it has fewer negative consequences than in others. It only means that somewhere it is considered to be a problem, but somewhere it is not accepted - depending on how generally at the community level a person’s feelings are recognized as a value. A community that seeks the emotional well-being of its members will have other limits to acceptability than a community for which the issue of survival is acute and it does not have enough resources to take care of subtle matters.
The client is not always right
A situation is possible when the community, for example, based on a cultural understanding of the norm, says to the individual: “You know, guy, you are sick, and you need to be treated,” and the individual, based on a functional understanding of the norm, answers this: “Leave me alone everything is good". In many cases, if an individual does not interfere with his functioning, such a position is justified. Sometimes an individual can have quite serious functioning problems, but it is easier for him to put up with them than to accept the idea that something is wrong with his psyche. The idea that you are mentally ill is very scary, and all the more scary, the more people with mental illness are stigmatized in the community. If, at the level of public consciousness, treatment by a psychiatrist is not very different from treatment, for example, by a cardiologist, then a person who has some mental disorder is much more likely to recognize its presence and seek help than when the treatment is done by a psychiatrist (especially in a hospital) is an indelible spot on reputation. The more ashamed to be mentally unhealthy, the more in the community there will be undiagnosed and untreated individuals who could function much better if they received adequate assistance.
The protective mechanisms of parents of special children work in approximately the same way. Being a mother of a “defective” child is a shame and a shame. Firstly, a mother’s own self-esteem depends on how developed, smart and successful her baby is. Secondly, she is afraid of the idea that she might be somehow to blame for the condition of the child. Thirdly, she already has some expectations regarding her unborn child, and she is often not ready to give up a positive image of the future, where her child will be a successful adult, and accept a different future, where she will devote many years to caring for the disabled person and trying to adapt him to this world (and the world to it). And this is a big problem, because sometimes it takes a mother several years to come to terms with the reality that the child has serious difficulties and needs help, and these are exactly the years when the help would be most effective. The degree of stigma here also plays a big role. When “down” is a word with a pronounced negative connotation, it is more difficult for the mother of a child with Down syndrome to speak out loud about the difficulties of the child, and those around him, respectively, are more difficult to perceive this child as a living person in need of support. Therefore, for example, films, books, comics are so valuable, where special people are present as characters. They spread the idea that such people happen to be living people with ordinary human problems (and some specific ones), and not unknown monsters.
- I have an autistic child.
- Like this?
“Well, he's like Sheldon from The Big Bang Theory.”
- Oh ok. My classmate was like that.
When there is no stigma, then the diagnosis becomes not a catastrophe, but simply a fact of life, which, of course, needs to be taken into account somehow, but life does not break down and end there.
In some mental disorders (for example, in acute psychoses), the ability to think critically is directly impaired. At the symptomatic level, this is manifested, for example, by delirium. At the same time, a person becomes unable to objectively assess his condition, because he loses contact with reality. We should not believe such a person if he says that everything is in order with him. But on the other hand, when he is in an acute state, we cannot convince him that he needs help, because rational argumentation does not work at this time. Under certain conditions, such a person can be helped beyond his will. Domestic legislation allows for the provision of psychiatric care forcibly in cases where a person is actively dangerous for himself and others, or he may die if he is not hospitalized. The latter is, for example, the case of an old woman who has become depressed, who lays on a sofa and stops eating. She seems to be not trying to cripple herself, but if this old woman is not treated forcibly, then she has real chances to die of hunger quietly on her couch.
Normally (in the sense that by default this usually works for adults), we first have some cognitive assessment of the situation, and then an emotion arises in response to this assessment. Accordingly, we can control our feelings by changing the description of the situation. If we describe ourselves as an unsuccessful person, we feel a sense of inferiority. It becomes much weaker if we change this description to a more detailed one, for example, like this: “I find it difficult to work in a situation of competition and competition, because I experience anxiety that prevents me from relaxing and focusing on work, and I'm afraid to be ineffective against the background others. " You can already work with this: for example, choose activities that are not related to aggressive competition. The statement “I'm stupid” with an increase in detail may turn into, for example, the statement “I solve mathematical problems more slowly, the greater part of people who study with me (but it’s easy for me to write essays, but it’s difficult for them)”, and this is already much less offensive.
With some mental disorders, this mechanics works the other way around: first an emotion arises, and already under this emotion a description of the situation is created. For example, first fear arises by itself, and then the psyche completes the justification. Why am I scared? Yes, because special services are hunting me, that's why! Therefore, such thinking is not available for rational argumentation. Its function is not to give a correct description of the situation, but to give meaning to a feeling that initially has no foundation. The specific delusional plot is selected from the cultural context in which the person is immersed. For example, the nonsense about the persecution by special services relies on the notion in the public mind that sometimes special services really harass some people.
The ambush here is that the higher the level of intelligence in a person, the more convincing and plausible justification he can build in a painful condition and, therefore, it is more difficult to diagnose.
Sometimes there is exactly the opposite picture: a person is well informed about his condition and is ready to inform others about him so that they are in the know and in case of which they are not surprised. And those around us, say, have never encountered psychiatry, exist in a survival mode and are used to not even paying attention to their own feelings.
“I could not work in the spring, I was depressed,” said a person suffering from depression.
- Depression is with him ... Yes, you are just a lazy bummer and you are looking for some kind of excuse instead of taking on the mind.
People with depression have very fragile self-esteem. From time to time they feel completely worthless and insignificant people. On the contrary, they would need to hear something positive and inspiring to themselves, and instead they will receive a heap of additional negative assessments.
With regard to children, the picture is similar:
- Sorry, my child has autism.
- Yes, you just do not raise him, so he rushes!
An additional burden falls on the mother of a special child: on the one hand, she has a huge amount of effort to try to regulate her child, and on the other hand, she needs to cope with the stream of condemnation from those who sincerely do not understand how difficult it really is .
Already not ordinary, not sick yet
There are several typical areas in which the psyche can change. A set of states with varying degrees of impaired functioning, but with similar manifestations and similar internal logic is called a spectrum. For example, there is a schizo-autistic spectrum, but there is a cycloid spectrum. The first, in a nutshell, unites "eccentrics", and the second - people with mood swings.
The spectrum has several levels. The core of the spectrum is violations of the psychotic level, which are characterized by the loss of contact with reality. In relation to the autistic spectrum, these are different forms of schizophrenia. A person in an acute psychotic state cannot understand where reality is and where painful manifestations are; delusions seem to him completely reliable, hallucinations are woven into reality. We will not be able to rationally explain to a person in this state that his ideas are not true, because at this moment he lacks criticism of himself and what is happening.
Does this mean that a person who is diagnosed with schizophrenia is constantly divorced from reality? Not at all necessary. There are forms with a continuous course, and there are paroxysmal. If a person has a paroxysmal form, then in the absence of drug therapy, he tends to periodically lose contact with reality for some time. For example, in the spring and autumn, the machinations of special services begin to disturb him very much, and then he actively conducts educational work, spreading technologies to protect the premises from listening using wire circuits and aluminum foil. Outside of seizures, this person can be quite adequate. He may be aware that he is sick, may be ashamed of his behavior during an attack, may be very interested in preventing exacerbations, and take a responsible approach to taking drugs. For example, the classic of domestic psychiatry, Viktor Kandinsky, had a paroxysmal form, and he described hallucinatory symptoms in schizophrenia, including on the material of his own case. Should we dismiss his work based on the fact that they were written by a mentally ill person? No, because at that moment when he wrote them, he thought clearly.
The second level is a violation of the psychopathic level. Here, a person maintains contact with reality, but he has a very difficult character - so much so that it seriously interferes with his functioning. Features of the psychopathic plan are characterized by the fact that a person is present constantly, throughout life, they appear in all situations, interfere with the person’s life and are burdensome for others.
And the third level is the level of character accentuations. Here we will see people who, in their manifestations, resemble those with disorders of a psychotic or psychopathic level. But they have the same features will be expressed more gently, and they will not interfere with normal life.
All representatives of the autistic spectrum share a number of common features. These are people who find communication difficult; they may be withdrawn, shy, or simply not interested in others. They give the impression of eccentrics: they choose words strangely, think unusually, behave unconventionally, as if deliberately ignoring the accepted norms (but in fact - not noticing, not feeling them). They are emotionally cool, often angular and awkward. It is difficult for them to realize their feelings, and they also feel weaker bodily needs (for example, they may not notice a feeling of hunger). They are prone to a high level of abstraction, so they are often attracted to mathematics. They may have unusual and very stable interests, and they are absorbed in what interests them. They like predictability and ritualism, they are people of habit and clearly formed preferences.
We will see these features in people with schizophrenia and in schizoid psychopaths - Asperger syndrome, in particular, can be considered as schizotypic psychopathy, and in schizoid accentuates. But we will consider some representatives of the autistic spectrum as having a disease, and others as healthy people whose condition is a variant of the norm. On what basis are we making this separation? We conduct it, understanding the norm in a functional sense - as the ability to learn, work, communicate, act in a team, build relationships.
If we are talking about a person with schizophrenia, then in the acute state, as we understand, he is incapable of work, because he is immersed in experiences and inaccessible to dialogue. As the disease develops, the so-called schizophrenic defect, a set of symptoms of loss, may increase in him. He gradually loses his feelings, the desire to maintain contacts, his level of activity falls, and at some point he may lose his ability to study and work, because he does not have enough resources to maintain a systematic focused activity. Such a person receives disability.
With schizoid psychopathy, a person maintains a fairly high level of activity and contact with reality, but it can be very difficult for him to adapt to the people around him. Firstly, he is not very interested in them, secondly, he can honestly not notice the rules and norms, and thirdly, his behavior is highly dependent on his own internal rules, rituals and experiences. An autistic child may simply refuse to enter the classroom, where something annoys him (too noisy, too colorful, and why the door, and suddenly it will be closed). If the schedule suddenly changes and you need to go to paint instead of mathematics, then this can cause terrible discomfort, up to protest reactions and hysteria, because the child knows for sure that mathematics should be, and the ritual is sacred. And there are many such difficulties. At the same time, the child may have a high level of intelligence, but learning is still difficult, because behavior is disturbed.
Does this mean that such a child can’t attend school at all? No, it doesn’t. Sometimes this means that the child needs a tutor who will accompany him in the classroom, taking on a part of the function of regulating behavior that the child cannot yet fully carry out independently, helping him to keep his attention on the subject and interact with other people. Sometimes this means that the child needs some alternative format of schooling. It happens that a child can sit in a lesson, but only if the class is small, because he needs a lot of individual attention and does not tolerate crowds. And so on. An unfavorable option is when the child is brought completely to home schooling, because he already has communicative difficulties initially, and if he does not get any communicative experience, the gap with peers widens and after some time can become insurmountable. It is very important for a schizoid or autistic child to communicate - precisely because it is difficult for him. Another unfavorable option is when the child is thrown into a crowded class of a mass school, and no one helps him adapt to this situation. If the child at this place disconnects from what is happening and goes into himself (for example, the whole lesson just sways peacefully), then the benefits of being in school will go to zero.
An adult who is well aware of his own characteristics and limitations may consciously strive to overcome them. We can meet autistic people who methodically learned to communicate through books, or autistic people who collect all available information about a person before making contact with him (they know exactly how and what to talk about with him). Such a person can achieve not just a normal level of functioning, but in the areas of interest to him even super-efficient. It will still be very unusual, and some of its “psychological crutches” will be much more energy-intensive than what they are intended to replace, but we can no longer say that the features of this person prevent him from living. We can call such a person successfully compensated.
Part of the adaptation of a schizoid or autistic person is the search for that environment, that niche of life where characteristic schizoid qualities will not only not be an obstacle to activity, but may even give a certain advantage. In particular, we will see a cluster of people with such a structure of the psyche among mathematicians, physicists, and programmers. At the stage of obtaining professional education, the social situation for schizoid people becomes easier, because they find themselves surrounded by their own kind, and it is much easier to agree with their own kind. At a minimum, there is no need to explain your troubles for a long time, when every second one has identical ones. The flip side of this is that adult schizoid people agree quite easily with each other, but they still find it difficult to interact with everyone else. Therefore, they feel more comfortable in work collectives, which again again consist mainly of schizoids. A separate plus of this situation is that when everything around is a little strange, your own oddities do not stand out against this background, and you can feel like a normal person (regarding this community).
Naturally, if there is compensation, then there is decompensation.If a person with schizoid accentuation, whose ordinary condition we qualify as a variant of the norm, finds himself in some intolerable circumstances for him, then his functioning may be disturbed for some time. Does this mean that he has become abnormal from normal? No, this only means that these conditions go beyond the range in which this person can function adequately. For example, if we put a closed, emotionally fragile schizoid on the phone so that he works there as tech support, then it will end very quickly, because it is not designed for such an amount of communication or the amount of emotions that some people can give out if they have something doesn't work. This person may begin, for example, to stutter and tick with his eye, and then completely fall sick. Does it mean that,Is this person a bad worker? No, this only means that he should not work as a technical support operator.
As we understand it, a person does not immediately and not immediately gain all his mental functions, capabilities and resources. There is a certain development process during which they are formed. Accordingly, we are talking about development standards - the expected age at which certain things become available. For example, until a preschooler has yet developed a theory of mind (or he has not yet learned to apply it), he will mention all kinds of Katya, Van, Anna Viktorovna and other people in a conversation with an adult, expecting that the adult understands who he is talking about. In the region of five years, a child can still do this by inertia, but he won’t be surprised if he requests additional information. And this is normal, because it corresponds to the age. But if a schoolboy talks like this, then this will raise some questions with us. We will have to be interestedthat this child has a communicative skill and does he understand that we are not familiar with these people. If an adult confidently believes that those around him “get thoughts out of his head”, then we may want to find a good psychiatrist for this adult.
Some things are generally regarded as pathological symptoms, but are considered normative at certain stages of development. For example, abundant and intrusive reflection with constant thoughts about oneself, about people and the meaning of being will be suspicious if we observe it in a thirty-year-old person, but completely normal in a teenager.
Another important point is that psychological development is not fully programmed, but largely depends on the environment and on the experience that a person receives. In particular, those preschool development standards that we use to assess how well a child develops and how successfully he learns the educational program were gathered decades ago, when many social development situations were different. Naturally, when a child does not have the opportunity to go to the yard and hang out with other children there for half a day without adult supervision, and when they give him a tablet with cartoons at home to neutralize his desire to communicate, this turns out to be a completely different speech situation, and therefore we should not to surprise if we see a lag in speech development in a child sample, let's sayfor a year from the adopted standards. It does not signal that the children are massively stupid, but that in the situation of development that children now have in the city, speech develops more slowly and more difficult than half a century ago. And again, we can approach this in different ways. We can call this effect pedagogical (that is, a slowdown in development due to an unfavorable environment). And we can decide that today's environment is neither better nor worse than that - it is just different. And then we accept other standards and decide that in such an environment it is natural for children to develop at such a speed. But if we look from a functional point of view, we will be interested in whether the child has enough of the speech skills that he manages to acquire to solve his life tasks: for study, for socialization, for building relationships. Upon discoveringthat places of speech skills are clearly not enough, we can say that the development is correct with respect to the environment (the child learned everything that he could in such circumstances), but the child’s functional capabilities are insufficient to solve the tasks facing him. Therefore, despite the absence of any developmental disorders, the child may still need developing activities and the help of specialists.
Who is bear with us
If we look at the situation of the first grade of the school, then some of the problems that children face there are very similar to the problems of role-playing characters at the initial level of development. For example, an intelligent boy comes to the first grade, a hereditary mathematician. Thin, a little clumsy, bespectacled, incredibly quick-witted. Who is it? This is the first level wizard. The problems of low-level wizards are known - they have very few spells (ways to indirectly solve problems), and they can be knocked out with one blow. If we release the first level wizard into the forest with goblins, they will eat him there. For example, let’s say the first goblin will fill up with the only spell he has, but fifteen will come for the first, and then it’s clear.
How can I get out of this problem? The first option is that we can multiclass the wizard. In relation to the boy - send him to practice some sambo or aikido. As we expect, after that he will be able to fight back if he is offended. But there are two nuances: firstly, if a character has low indicators of strength, dexterity and endurance (imagine a bony, short-sighted child), then a warrior from him is doubtful, even if he goes through combat training. And secondly, the wizard has his own tasks (to read many books, first of all), for which he needs a lot of time. And we stop the wizard from developing like a wizard when we try to make someone else out of him.
The second option, which can usually be observed in board role-playing games, is when the problem is solved through cooperation. An individual wizard is knocked out with one blow, but if he faces four warriors (who love him very much because he allows them to write off mathematics), then this is a completely different story. Now, at this level of development, the wizard is in a weak position, and he needs support. Wizards start weak and swing for a long time, but when they reach high levels, they gain tremendous opportunities, and there the balance of forces can radically change. That is, twenty years later, we can see the same bespectacled boy as a big boss, to whom the very guys who once had to hide behind would come to get a job.
For this to work, the wizard needs a certain level of social skill and certain ideas in the picture of the world. For example, if he is convinced that the value of a person is measured by intelligence (“I will not be friends with fools”), he will not be able to join such a cooperative. He will not be able to join such a cooperative if he is convinced that his brains and the results of his intellectual work are his personal property, and not the resource of the group. If he is ready to share what he is stronger than others, it is natural that they will be treated much better, and in return he will also receive some group resources (in particular, the same physical security).
If we look at a large society, then we can see similar processes there. For example, there are people who consciously choose the profession of doctors and teachers, understanding that it will be hard, thankless and, most likely, poorly paid work. They choose these professions because they want to take care of others. It is difficult for these people to defend their own interests, and they will meekly continue to do their own thing, even if they are steadily worsening working conditions. Is it their strength or weakness? Relative to a single person - weakness, because they themselves can not take care of themselves. A relatively large society is power, because it is precisely such people who are able to carry culture and humanistic values ​​through hunger, war and a market economy. What kind of people are these? These are priests, clerics.If we release a single cleric into the forest with goblins, then without a command he will be there as sour as a wizard. But a team without a cleric will also have a hard time. If at the level of a large society there is an awareness of the value of such a role, then representatives of social professions have decent working conditions, they are taken care of. But a large society can abuse their humility and progressively load more and more work on worse conditions. Then we will see the clerics burn out: they will work until they have enough strength, and then the forces will run out, and they will either change their occupation, or they will change their worldview and turn from good heroes into evil ones. Too many indifferent doctors and vicious school teachers are such burnt clerics. It is clear from here why women dominate in social professions:if a cooperative at the level of a large society ceases to work (say, a doctor’s salary in a clinic allows only a miserable existence and does not allow to feed a family), then a woman in this situation can rely on a family cooperative structure and continue to fulfill her social role, and a man is most likely , will have to look for some other job, because he is more responsible for the material well-being of his family.because he is more responsible for the material well-being of his family.because he is more responsible for the material well-being of his family.
Short
What is the general idea here? People are different, and that's normal. The concept of a psychological norm is not associated with the same, but rather with the ability to function quite effectively in ordinary, not extreme conditions. We will talk about a violation not in the case when a person is different from others, but in the case when he can not cope with certain fairly ordinary situations: such as schooling, for example. We do not expect that any “normal” person will be able to solve any problem exclusively on their own, but an important element of successful adaptation is the ability to use the resources of a group or a large society in cases where there are not enough personal capabilities.
Accepting a diversity of people helps to better understand and consider the capabilities and needs of each individual - which can also be very diverse. If a person needs some specific conditions for optimal functioning, this in itself does not mean abnormality: only that this person has certain individual characteristics.