I recently realised that people with diametrically opposing views on the existence and validity of conditions like autism, appear to make the same argument about the modern trend to “pathologize normality.” So I decided to break-down the argument that is otherwise so briefly summarised in that phrase. At which point it became clear that the “pathologizing normal” argument can stand for (at least) two very different views of humanity and of mental difference; that the seeming agreement on the phenomenon was strictly superficial. So, for the sake of clarity – and the hope of more open dialogue next time I encounter the phrase – I want to attempt to explain these two versions, as I understand them.
The first version goes something like this: There is a modern trend to put labels on completely normal children. On children who are just a little shy or withdrawn, or just full of energy, or just poorly disciplined. These children don’t have ADHD or Aspergers or ODD etc, they’re just the perfectly normal kids we’ve always had in society, but are now receiving these trending labels because of various motivations. Examples of those motivations include parents who refuse to accept their own parenting is at fault, and clinicians who want to make money from providing therapies and drugs to these kids. When it comes to adults seeking and attaining these labels for themselves, it is because these adults want excuses to behave poorly / avoid taking responsibility for their behaviour. The fact is that conditions like these don’t exist. It’s just the pathologization of normal (however undesirable or unpleasant that “normal” may be).
The second version of the argument goes something like this: Conditions like Aspergers, ADHD etc, are real “conditions,” but they are part of the normal human spectrum of experience and existence. These conditions are treated though as if they are wrong and need “correcting:” These people are put on drugs and through endless therapies and in other ways told that what they are is wrong and must change. Instead we should be supporting and encouraging these individuals to be the best they can with their talents, and to work with their challenges in a positive light. We shouldn’t be labeling them as sick or deficient, to do so is to pathologize normal.
This second argument often comes hand-in-hand with an attack on any attempt to define “normal.” They frequently question the validity of a distinction between “normal” and “abnormal,” instead using the word “normal” in this context to capture the point that human experience is brilliantly diverse and valid in all its diversity: That pathologizing people with Aspergers (etc) is a denial and attack on that necessary and natural diversity.
Both versions of the argument have a few things in common: Concern about the impact – and abuse – of labels; concern about the perceived readiness with which professionals turn to drugs to deal with “troubled” people; and concern that various conditions are included in mental health manuals at all (or the ways in which those conditions are defined in those manuals). However the views clearly and seriously diverge when it comes to perceptions about the legitimacy of the conditions at issue, and that is at the very core of the first version of the argument. Furthermore, the seeming agreement on the concerns listed above, is largely superficial.
For example, whereas the first version of the argument would see a label like “Aspergers” to be negative and unhelpful, the second version may see the label as something helpful and positive to be proud of. And whereas the first version argumenters might want conditions like these wiped from the “mental health” manuals altogether (and not continue to exist anywhere else either), the second version arguers may wish the conditions to be less negatively defined and not be considered a type of “disorder” rather than a difference.
So next time you encounter someone who wants to run a short-hand argument that we’re seeing a modern trend of pathologizing the normal – that what was once treated (or should be treated) as normal and natural, has come to be seen as sick and abnormal – before you agree with them and wonder how you disagree on everything else but see eye-to-eye on this, now perhaps you’ll be better able to identify just how deep that disagreement really runs. I, at least, have been in this position in the past and not being able to pin-point the very real difference in views.
I’d be interested to hear whether you have used the shorthand “pathologizing normal,” what you personally meant by it, and why you hold the view. I know some of my commenters in the past have tried to argue that this is a modern trend, I would love to hear whether I’ve captured your concerns, or if there’s a third version of this argument that I haven’t even considered yet.