The Discourse of Abnormal Behavior

Discourse is a term used for the way that language influences thinking about a certain subject; in many occasions discourse defines power relations: how person A can talk about person B gives them some amount of power over person B. Because of what a diagnosis of mental illness means about a person’s past and present and because it can determine somewhat their future, the discourse that surrounds mental illness is one such disempowering discourse.

The language used by psychiatry, for example, assumes that there is some fault with the individual and ignores that fact that "cultures establish normative criteria for what is acceptable behavior within that culture.” (Crowe 2000: 69). Basically the idea is that nothing is abnormal until someone with power says it is; further, what is considered abnormal by some cultures may not be considered abnormal by others.

American culture, as hinted at in the previous post, values characteristics like rationality; as such, it is “normal” to behave “rationally.” Michael Crowe outlines a number of other such characteristics which are considered to be essential aspects of normal behavior. Firstly, certain eating, sleeping, and social behaviors, as well as energy levels “should be maintained consistently to ensure productivity despite their social and environmental context” (Crowe 2000: 73). Second, there is a certain sense of self that a person must have to fit into individualist Western culture; one cannot be too grandiose, but at the same time, one must not have diminished sense of self-esteem. The DSM-IV thirdly stresses the importance moderation, categorizing both excessive and minimalistic behaviors as abnormal (Crowe 2000:73-75).

Crowe further goes on to show how the DSM-IV uses the absence of these characteristics to define abnormality. Examining the DSM-IV reveals that many if not all of the “symptoms” of bipolar disorder fall into Crowe’s categories, including “fatigue or loss of energy nearly every day” (DSM-IV 327), “inflated self-esteem or grandiosity”, “excessive involvement in pleasurable activities that have a high potential for painful consequences” (DSM-IV 332), and “diminished ability to think or concentrate, or indecisiveness” (DSM-IV 327).

The DSM-IV therefore is basically a classificatory system which divides people into normal and abnormal categories. This is not to say the mental illnesses and bipolar disorder aren’t real, because they are, and they cause a lot of problems for people with them. However, I do mean to suggest that there is nothing truly abnormal about bipolar themselves until they clash with societal norms and values and most especially when they are diagnosed.

There are other cultures which do not value individualism or productivity or rationality nearly as much as American cultures, and we have to ask the question: would we, as bipolar, be mentally ill if we lived in these cultures? And if not, what does it mean that we are mentally ill in this one? What has been taken away from us? And how can we get it back?

Further Reading

Crowe, M. (2000). Constructing Normality: A Discourse Analysis of the DSM-IV. Journal of Psychiatric & Mental Health Nursing, 7(1), 69-77. doi:10.1046/j.1365-2850.2000.00261.x

The Discourse of Abnormal Behavior