PS440 Unit 1 Defining Abnormality Board Post Example

Two Guests Who Heard Voices: A PS440 Unit 1 Discussion Post on Defining Abnormality

PS440 · Unit 1 Discussion Board Post

Posted by [Student Name]

The writer, the crisis center, its guests and the classmates are composite; the sources cited are real.

Initial Post

I work overnight as a behavioral health technician at a 24-hour crisis care center in Rapid City, South Dakota, where adults in a mental health crisis can stay for a few days instead of going to an emergency room or jail. Two guests this month made me rethink how we decide that something is abnormal.

Marlene, 71, lost her husband of forty-six years in February. Since then she sometimes hears him call her name at dusk, the time he used to come in from the barn. Her daughter brought her in, afraid she was losing her mind. Marlene was embarrassed but calm. She said the voice comforts her, she is eating and sleeping, and she still runs the ranch books. Corey, 23, arrived with a sheriff's deputy after he pounded on a neighbor's door at 3 a.m. demanding that they stop broadcasting his thoughts. Four sleepless nights, a job he had walked away from and plain fear were written all over him.

Textbook criteria handle these two poorly. Both experiences are statistically unusual. Both caused distress, though for Marlene the distress belonged to her daughter. If deviance and distress were enough, both would count as disorders.

Wakefield (1992) required two things before calling something a disorder: a mental mechanism must be failing at the job it evolved to do, and that failure must do damage that the surrounding culture recognizes as harm. That approach separates the two cases. Hearing a dead spouse is common in grief; a review found such experiences in a large share of bereaved people, often felt as comforting and not linked to later mental illness (Castelnovo et al., 2015). Nothing about Marlene's thinking, mood or daily life suggests a mechanism has failed. Corey's beliefs, by contrast, have cut him off from work, sleep and his neighbors, and he cannot step back from them.

What made Corey's experience a disorder was not that it was strange, but that it had broken his ability to sleep, work and live next to his neighbors.

The model has its own difficulty: it assumes we know what a mental mechanism was designed to do. Who decides what counts as the natural function of grief?

What experience have you seen that is unusual but not a disorder?

Reply to Ana

Ana, your example of a coworker who checks the stove five times before leaving is a good test of the harmful dysfunction model. Wakefield (1992) would ask whether the checking interferes with her life. If she is ten minutes late every day and cannot stop, harm is present; if she checks quickly and moves on, it may be a habit rather than a disorder.

Reply to Josh

Josh, I agree that culture matters, and your point about speaking in tongues during worship is a strong case. An experience that would worry a clinician in one setting is expected and valued in another, which supports Wakefield's view that the harm part of the definition depends on social values.

References

Castelnovo, A., Cavallotti, S., Gambini, O., & D'Agostino, A. (2015). Post-bereavement hallucinatory experiences: A critical overview of population and clinical studies. Journal of Affective Disorders, 186, 266-274. https://doi.org/10.1016/j.jad.2015.07.032

Wakefield, J. C. (1992). The concept of mental disorder: On the boundary between biological facts and social values. American Psychologist, 47(3), 373-388. https://doi.org/10.1037/0003-066X.47.3.373