Am I Normal?
Originally published on August 7, 2017 via WordPress
One of the most common questions I’m asked by therapy and testing clients is “Am I normal?” It’s a fair question, and it makes sense that some people view psychologists as the people trained to give a solid answer. After all, one of the core educational requirements of anyone seeking a graduate degree in psychology is a course in “Abnormal Psychology.” It can certainly be fascinating to learn about “outliers” in any human trait—intelligence, athleticism, narcissism, and so forth. Plus, in order to accurately assess and diagnose, we need a framework for organizing whatever it is we are assessing and diagnosing. As such, the foundation of our field for the last century has been rooted in “mental illness” being just that—a diagnosis or label, assigned to people whose presentations are “not normal.” So I get why this is the burning question.
“Normal” in 2017 is more elusive than ever. With technology at our fingertips, we ask Google, Wikipedia, and WebMD to weigh in. Social media has perhaps been most influential, taking the “am I normal?” question and providing “answers” by showing us what “everyone else” is doing with their lives. What does a “normal” body look like? A “normal” family? A “normal” person’s Saturday night?
Consult social media, where you can decide if you measure up to the curated online images of people popping up in your newsfeed. For some people, it’s easy to feel lame and unsuccessful when it’s “normal” to censor ourselves and only show the public the highlights reel. For others, it’s a constant competition to set the new standard. I wonder what would change if everyone knew how much everyone else was asking whether “it’s normal to [fill in the blank]?” Maybe we’d have more tolerance for the full spectrum of our daily experiences if we could accept that “normal” doesn’t exist.
Perceptions, thoughts, feelings, sensations, and memories are subjective. They are often driven by context and filtered through the lenses we’ve developed through life experience. So what’s “normal” in one context may not be seen as normal in another. Walking down the sidewalk with one’s nose to the ground, sniffing for discarded food scraps = unusual for a human, “normal” for a dog. Sucking one’s thumb = unusual for a 45-year-old, “normal” for a 2-year-old. However, context isn’t always as clear as one’s species or age. Is it “cautious and smart” to lock and then double-check the locks on your doors and windows at night, or is it “paranoid and obsessive” to do so? It depends.
It’s “normal” (natural?) to be curious about whether our experiences and behaviors can be considered appropriate, acceptable, or healthy. But who is the authority on what is considered appropriate, acceptable, or healthy? Psychologists? We’re people too! I’m not the authority on “normal” just because I can tell you if you match up to an agreed-upon set of criteria published in a scientific manual. The reality is that you are the authority on yourself, so only you can answer whether your experience is adaptive or not.
For example, anxiety is “normal.” In fact, it’s a human necessity. It keeps us alert to danger and motivated to complete tasks. Without any anxiety, we have no urgency to get anything done. With too much anxiety, however, we become too overwhelmed to be productive. Finding that “sweet spot” of optimal anxiety for optimal performance on top of the inverted “U” illustrated by the Yerkes-Dodson Law is the key to success. That sweet spot, however, is subjective to the individual experiencing it.
Current research shows that mental “illness” might be more of the “norm” than the outlier. The Dunedin Study in New Zealand has followed over 1,000 people from birth and over the course of their lives for the past 40 years, assessing them every few years to look at various health and mental health conditions. The most recent “check in” with study participants took place when they were 38-years-old. So far, only 17 percent of the sample has never met any criteria for a psychiatric disorder at any time in the study’s assessment points. This means that at some point in your life, it is likely that you meet criteria for a psychiatric diagnosis (most commonly something like depression, anxiety, an adjustment disorder, or substance abuse). While of course no single study can be generalized to reflect the whole world’s population, it gives us some pretty solid data.
Given these findings, we could argue that it’s “normal” to experience depression at some point in one’s life, just like it’s “normal” to get the flu or break a bone at some point in life. Whether your symptoms warrant treatment depends on how the symptoms are interfering with your life. Everything falls on a spectrum; just as there is a difference between bumping your head and bumping your head with such force that it’s deemed a concussion, there is a difference between feeling a flash of anxiety before a big presentation and feeling such debilitating anxiety that you cannot speak.
The newest version of the Diagnostic and Statistic Manual of Mental Disorders (DSM5), which mental health professionals use for making clinical diagnoses, has shifted towards a more dimensional approach that matches this concept of everything falling along a spectrum. Hopefully, in future editions, it will move even further away from categorizing people as “normal” vs. “abnormal” and help us remove the stigma from these diagnoses, especially since most diagnoses can be temporary. So is it “normal” to struggle at some point, and to have symptoms intense enough to meet criteria for a diagnosis? Absolutely. It’s part of being human.
Maybe we can let go of the need to know if we are “normal” and instead ask ourselves, “does this work for me?” or “is being this way helping me live a meaningful life?” When I first meet with someone seeking therapy, I ask them the “miracle question,” some variation of the following: “If I waved a magic wand and you walked out of here today completely cured of your [depression, anxiety, painful trauma memories, addiction, etc.], what would be different about your life? What would you be able to do?” Usually, the answer has something to do with more meaningful relationships with loved ones, a rewarding job, more energy, etc. Those answers become our treatment goals. If you’re able to move towards your values, the things that truly matter to you, then isn’t that more important than knowing if you’re “normal” by someone else’s standards?