Slightly revised from the article published in The Humanistic Psychologist, 42, 3, 2014

Pathological Normalcy: A Construct for Comprehending and Overcoming Psychological Aspects of Alienation

Carl Ratner

Institute for Cultural Research & Education

www.sonic.net/~cr2

Daniel Burston has made an incisive contribution to broadening and deepening the field of academic psychology. In his article in vol. 42, 2 of The Humanistic Psychologist “Cyborgs, Zombies and Planetary Death: Alienation and the Fate of Humanity in the 21^st Century" he brings an impressive scholarship of European social theory to the field of psychology. He uses this to illuminate important features of contemporary capitalist society and he shows how these bear on psychological issues.

The reader is treated to a masterful introduction of important social theorists such as Heidegger, Lacan, Fromm, Lukacs, Goldmann, and others. Burston utilizes their social theories to make incisive observations about contemporary capitalism. Especially important is his critique of markets as alienated, depersonalized, instrumental, egotistical, materialistic, transient (“liquid” in Baumann’s terms) social relations. These features of our fundamental economic institution are clearly responsible for psychological problems.

Burston pinpoints the important issue of whether alienation is socially constructed and changeable, or whether it is intrinsic to civilization and the human condition. He points out that Marx articulated the former position while Heidegger and Lacan adopted the more pessimistic latter position. Lacan went so far as to build alienation into language!

Burston urges us to evaluate these claims and their relation to each other. (Face value suggests that a grand synthesis is not possible. Alienation cannot be historically constructed-changeable and also intrinsic to human nature.) Burston seems to favor Marx’s position, (however he does not present an argument for it). He urges us to use this notion of alienation to understand -- and then solve -- social problems.

This is important advice because it directs us to look deeply into the causes and characteristics of alienation to discover alternatives to them. I would like to take up this challenge by exploring Fromm’s work on alienation. I will also critique contradictory concepts from other approaches that fail to probe alienation and its implications for social and psychological critique and enrichment.

Following Marx, Fromm recognized that alienation is first and foremost a social, structural phenomenon — people are alienated from their work activity and the products of this activity because these have been expropriated from the worker-producers by the capitalist owners of the means of production, who generally control the levers of government. This condition includes psychological elements that Burston enumerates. These include mystification, commodification, and stultification. Fromm termed these “The Pathology of Normalcy” (Fromm, 2010). Fromm meant that normal social life in contemporary societies is pathological (oppressive, destructive, debilitating, stressful, dehumanizing, mystifying, stupefying). Quantitatively normative behavior (represented in a bell-shaped curve) is not qualitatively normal in the sense of being healthy or fulfilling. On the contrary, pathology is normal (normative). Freud emphasized this in his book “The Psychopathology of Everyday Life.” Sociologists such as C.W. Mills used the term social pathology (see Rieber, 1997).

Ratner calls these psychological aspects of social oppression “the psychology of oppression” (Ratner, 2011, 2014a, b). These designations do not claim that social and psychological activities are completely oppressive. Capitalist society certainly contains many enriching factors, conditions, reasoning, personality attributes, emotions, etc. The psychology of oppression, and pathological normalcy highlight many (not all) fundamental factors, conditions, and psychological phenomena.

Psychology of oppression and pathological normalcy are critical constructs in the best sense — they combine intellectual analysis with practical, political change. Their analysis of normal pathology leads to changing normal society that is pathological and that generates personal pathologies. Indeed, only these kinds of concepts are adequate to comprehending society and improving it. Consequently, they are vital to humanistic psychology that strives to advance humanistic life. Concepts that minimize the pathology of normalcy are blind to the need to change normalcy.

Of course, social change is threatening to normal, non-humanistic society. Consequently, critical concepts such as alienation, “pathological normalcy,” “normal pathology,” social pathology, and psychology of oppression must be denied by the status quo. This denial takes two forms in the arena of Psychology. It is important to critique both forms because they impede social critique and transformation that are vital to social science and social reform.

Denying Pathological Normalcy and Normal Pathology

A. Externalizing pathology by misrepresenting it as outside normal social life and due to abnormal psycho-biological factors.

Social and psychological pathology is attributed to non-societal causes such as biochemical abnormalities, accidental trauma, personality defects, and disturbed interpersonal interactions. Pathology is ab-normal rather than normal. This leaves normal life (the status quo) appearing to be healthy and fulfilling.^{^[1]}

The increasing pathology of the status quo generates increasing numbers of destructive and debilitating behavior. "25% of U.S. adults experience a mental health issue in a given year." 66% of visits to family physicians involve stress-related symptoms" (Wall St. Journal, Sept. 25, 2013, p. A4). Social aggression -- social exclusion, verbal bullying -- is being noticed among American kindergarteners. 50% of children in grades 5-12 have experienced social aggression at least monthly. The broadest, most complete measure of normal pathology is the U.S. military’s figure that 71% of 17-24 year olds are unqualified for military service. The reasons include physical (e.g., obesity), behavioral (substance abuse, mental illness, crime), and educational (lack of high school diploma, and even 25% of high school graduates fail the Armed Forces Qualification test in math and reading; Wall Street Journal, June 28, 2014). Since these stresses must not be traced to normal society stressors, psychologists and psychiatrists and policy makers must attribute social-psychological problems to increasing numbers of individual defects. This shows up in the continual expansion of the DSM to encompass more and more behavior as ab-normal. It also shows up in the increasing medicalization of individuals who display problematical behavior. The number of American adults receiving prescriptions for A.D.H.D. drugs had risen 53 percent, to an estimated 2.6 million in 2012 from 1.7 million in 2008. Use among young adults ages 26 to 34 almost doubled, to 640,000 from 340,000, during the four years. In 2012, 5.7 percent of all children ages 4 to 18 were being prescribed A.D.H.D. medications, 7.8 percent of boys and 3.5 percent of girls. (More boys receive the diagnosis because they tend to appear more hyperactive.) Among adolescents 12 to 18, however, the rates reached 9.3 percent of boys and 4.4 percent of girls (New York Times, March 12, 2014).

ADHD is defined by DSM-IV as inattentiveness, hyperactivity and impulsivity: makes careless mistakes in schoolwork, work, or other activities, is often ‘‘on the go’’ or often acts as if ‘‘driven by a motor." These are clearly normative behaviors in competitive, consumerist, profit-oriented capitalism. As their prevalence becomes normative, abnormal psycho-biological causes are increasingly invoked to explain them.

Misconstruing the causes, mechanisms, and characteristics of psychological problems obviously subverts any scientific pretensions these theories and practices proffer. Real treatment and prevention is also prohibited. Ross (2013, p. 195) shows that

there is no physiological specificity to any mental disorder; there is no genetic specificity to any mental disorder; and there is no symptom specificity to DSM-5 disorders. DSM-5 disorders, according to the manual, have porous boundaries with each other, have high rates of comorbidity, and fluctuate a great deal over time. The risk genes for mental disorders number in the hundreds, each contributes perhaps 1%–2% to the overall risk, and the same genes confer risk for multiple DSM-5 categories of disorder. The idea that DSM disorders are separate diseases with distinct pathophysiologies has been disconfirmed by the DSM-5, and therefore by the American Psychiatric Association, as it has by the National Institutes of Mental Health (see Strand, 2011 for insights into certain social bases of the DSM).

The demographic distribution and escalating incidence of psychiatric disorders render intra-individual explanations of psychological pathology implausible. For there is no way to explain simultaneous increases in intra-personal defects among social groups at particular times. Why are so many more individuals now defective? How could millions of individual defects coincidentally arise at the same time among certain demographic groups? The only intelligible explanation is that common individual deficiencies are generated by broad macro cultural forces that encompass millions of individuals.

Pathologizing behavior includes criminalizing it. Crime is an individualistic notion — the individual criminal is the problem; she is a defective, “under-socialized” individual who disobeys societal rules. Society is normal; the individual is defective. As society becomes increasingly pathological and generates more pathological behavior, it must criminalize more behavior/individuals in order to nominally invert the causes from social to individual.

Pathologizing/criminalizing behavior strengthens the status quo by justifying greater defense of the status quo against the rising tide of individual pathologies. Thus, the problematical social system that needs to be transformed is instead defended. This generates more social and psychological problems.

Another gambit that obfuscates normal pathology is to tout its macro cultural causes as fulfilling. The new language of institutions is freedom, efficiency, competitive, flexible, nimble, responsive, transparent, consumer-oriented, cost-conscious, individual choice, individual responsibility, and even ecological. There is no mention of exploitation, hierarchical, alienation, imperialism, empire, commodification, depersonalization, precarious, uncaring, corrupt, or polluting — except as anomalous oversights. Misrepresenting the oppressive social causes of disturbance as beneficial leads to concocting intra-individual surrogate causes as the only apparent explanation.

The corrective to marginalizing-pathologizing-medicalizing-criminologizing social-psychological pathology is to reconceptualize it as normal pathology. The pathological must be reconnected to normative macro cultural factors. This identifies its normative social basis, and it directs attention to transform this normative social basis. This is how alienation can be utilized to advance our humanity. Unfortunately, this corrective is rarely pursued. Instead, a different approach has become popular:

B. Denying the entire concepts of normality and pathology altogether.

According to social constructionists, individualists, agency theory, and cultural relativists, normality and pathology are arbitrary labels that privilege mainstream behavior and stigmatize non-conformity. Behavior is neither normal nor pathological. Behavior is simply the self-expression of the subject. Differences should not be construed as (quantitative) deficiencies or superiorities. On the contrary, all diverse behaviors should be exalted as testifying to individual freedom of choice and expression. The more, the better. This requires withholding any social label that endorses or stigmatizes any behavioral forms. Pathology and normality are less descriptions of behavior than prescriptions for controlling it. It is labels that constrain, coerce, and contort behavior. Labeling theory calls for the destruction of social labels on behavior -- whether good or bad.

Obesity, for example, is generally condemned as pathological. However the diversity-constructionist-relativist position disputes this. It claims that being fat is an individual, agentive life style that is no worse than any other. Fat people claim civil rights to be as fat as they wish. They denounce pathologizing it as an arbitrary social stigma that seeks to impose a hegemonic slimness upon all individuals to simply enforce social values, not science (O’Hara & Gregg, 2012).

Another example is the communication style of poor children in school. School officials denounce ungrammatical and illogical communication styles as incorrect and unintelligible, and seek to correct it in line with middle class communication styles. The “diversity” position repudiates this corrective as mere social conformity that squelches cultural and individual diversity. There is nothing wrong with poor students’ communication; it is simply different from middle class communication. It should be respected and even celebrated for its enriching difference.

This diversity-relativist-constructionist-individualistic position seeks to correct pathologizing of behavior by denying all pathology. Nobody can be pathologized/stigmatized because there is no such thing as pathology. And no one way of functioning can be privileged as normal for the same reason. Behavior is entirely individual, neither normal nor abnormal.

The reason pathology is denied is that subjectivity is construed as defining itself. Agency is inherently creative so it can negotiate, circumvent, and resist (“co-construct” in Valsiner’s term) disturbing outside influences — thereby rendering them irrelevant. Subjectivity is autonomous, personal, and self-directed. Consequently, it is to be validated for itself in any of its chosen, diverse, relativistic expressions. Whatever agency decides to do is its business, nobody else’s. External observers cannot comprehend the unique, personal, interior, subjectivity of another autonomous individual. External evaluations of subjectivity infringe upon the individual freedom of the subject.

We may see that the psychological position that denies pathology is rooted in a broad social philosophy of individual freedom, authenticity, personhood, agency, and subjectivity. This social philosophy is essentially postmodernist and neoliberal. It grants full autonomy to individual subjectivity. It divorces individual subjectivity/agency from external influences such as social structures, conditions, factors — and judgments. It eschews social standards, criteria, and definitions because they transcend, organize, and objectify free-floating, spontaneous, subjectivity.

However, this is a purely nominal, idealist form of respect or emancipation. It declares individuals to be autonomous and agentive without transforming oppressive social conditions. It regards subjectivity as something that needs to be recovered and expressed, not as something that needs to be developed via social improvement.

Postmodern individualistic subjectivism fails to acknowledge that individuals are not autonomous under current and historical social conditions. True emancipation only comes from transforming oppressive social structures and conditions. Postmodernism refuses to work through oppression by analyzing its social structural basis and a social structural alternative. This entraps people in the extant reality of oppressive society and psychology. It mystifies freedom by declaring people to be subjectively free when they are not.

Consider psychological distress. Oppressive society distresses peoples’ psychology. Ignoring this, and claiming that all psychological expressions are simply individual, agentive styles that cannot be stigmatized as better or worse, entraps people in their distress. Removing psychiatric labels does not remove pathological conditions and states of mind. (Just as respecting oppressed people by changing terminology from Negro to Black, or garbage man to sanitation worker, or secretary to administrative assistant alters nothing about their oppressive socio-economic positions.)

Similarly, obesity is pathological. It is unhealthy. It cannot be glorified as an individual, agentive act that empowers and fulfills people. Obesity is socially determined, and it is infused with oppressive aspects of normal, class society.

The same is true of poor students’ communication style. It is conditioned by their social class; it functions to maintain their lower class position. It is not a spontaneous act of agency that expresses and fulfills the speakers.

Regarding these acts as free expressions of agency only obfuscates oppression under the name of subjective freedom. (This is one reason that the terms social pathology and deviance have disappeared from sociology; Best, 2006).

Pathological Normalcy Is An Emancipatory Scientific and Political Construct

Critiquing behavior as pathological normalcy leads to a) critiquing its oppressed character, b) tracing it to oppressive, alienating macro cultural factors and politics, c) calling for structural change in these factors to humanize society. Pathological normalcy leads to a valuable scientific understanding of psychology/behavior, and to valuable insights for humanizing society on a practical, political level. Pathological normalcy provides us with a foundation — need and direction — for real social and psychological change. Critique does not stigmatize or punish individuals (Ratner, 2012a, b).

The error of pathologizing pathology is not in identifying/labeling pathology; the error is in explaining pathology in terms of ab-normal factors rather than in terms of normal oppressive factors. The corrective to pathologizing pathology is to recover its basis in normative, mainstream, society, not to deny pathology altogether. The corrective is to pathologize normalcy and to normalize pathology. Pathological social factors must be precisely and concretely identified and tied to a political-economic mode of production (Best, 2006) -- as Fromm and Marcuse did.

Psychological critique and social critique are necessary to scientifically understand people, and to help them humanize and emancipate themselves from social oppression. Critiquing people does not stultify them, it frees them from stultification. Conversely, adulating people does not free them from oppression, it perpetuates their oppression.

Social improvement begins with social critique. Social critique must be built into theoretical constructs of social science and psychology. Alienation, pathological normalcy, and psychology of oppression are critical scientific constructs that promise to aid this task.

Social critique is abandoned by dispensing with pathological normalcy and (1) replacing it with abnormal pathology that is segregated from society, and (2) disavowing pathology. Both of these converge in exempting normal society from critique. This obfuscates the basis of social and psychological problems, the need to change this basis, and the direction that social and psychological improvement must take.

References

Best, J. (2006). Whatever happened to Social Pathology? Conceptual fashions and the sociology of deviance. Sociological Spectrum, 26, 533-546.

Fromm, E. (2010). The pathology of normalcy. N.Y.: American Mental Health Foundation Books.

O’Hara, L., & Gregg, J. (2012). Human rights casualties from the “war on obesity”: Why focusing on body weight is inconsistent with a human rights approach to health. Fat Studies, 1, 32-46.

Ratner, C. (2011). Macro cultural psychology, the psychology of oppression, and cultural-psychological enrichment. In P. Portes & S. Salas (Eds.), Vygotsky in 21st Century Society: Advances in cultural historical theory and praxis with non-dominant communities, chap. 5. NY: Peter Lang.

Ratner, C. (2012a). Macro cultural psychology: A political philosophy of mind. N.Y.: Oxford.

Ratner, C. ( 2012b). Macro cultural psychology: Its development, concerns, politics, and future direction. In M. Gelfand, C. Chiu, Y. Hong (Eds.), Advances in Culture and Psychology (vol. 3, chap. 6). N.Y.: Oxford University Press.

Ratner, C. (2013). Cooperation, community, and co-ops in a global era. N.Y.: Springer.

Ratner, C. (2014a). The psychology of oppression. In T. Teo (Ed.), The encyclopedia of critical psychology, N.Y.: Springer.

Ratner, C. (2014b). False consciousness. In T. Teo (Ed.), The encyclopedia of critical psychology, N.Y.: Springer.

Rieber, R. (1997). Manufacturing social distress: Psychopathy in everyday life. N.Y.: Springer.

Ross, C. (2013). Biology and Genetics in DSM-5. Ethical Human Psychology and Psychiatry, 15, 3, 195-198.

Strand, M. (2011). Where do classifications come from? The DSM-III, the transformation of American psychiatry, and the problem of origins in the sociology of knowledge. Theory and Society, 40, 273-313.

Notes