Tuesday, August 9, 2011

Normal: It Ain't What It's Cracked Up to Be

This is my second installment in our conversation on Nassir Ghaemi’s “A First-Rate Madness: Uncovering the Links Between Leadership and Mental Illness.” (See The Normal Paradox.) Dr Ghaemi is by no means the first to comment on the positive association between manic-depressive tendencies and outstanding achievement, but he goes much farther by calling “normal” into question.

Basically, Dr Ghaemi is asking: If the right kind of crazy is optimal in times of crisis, what does that say for normal? Can’t we at least regard normal as serviceable in a pinch? No, is his unequivocal conclusion.

The basic fallacy about normal, if I am interpreting Dr Ghaemi correctly, is that this condition (yes, let’s call it a condition) leaves a lot to be desired, in the first place. Dr Ghaemi’s starting point is a study from about 50 years ago by one of Freud’s last disciples, Roy Grinker.

Dr Grinker screened a group of 343 college-age men, out of which he selected 65 he deemed to be in the middle of the mentally healthy range. Based on subsequent interviews, Grinker came up with a detailed list of mental health attributes for these “upright young men.”

There was, however, a major catch. These paragons of mental health suffered a severe case of “average-itis.” They had slightly above average IQs, their grades were average, and they were not leaders on the team sports they had played in high school.

In effect, their main positive attribute was they played well with others. Dr Grinker came up with the term “homoclite” to describe these drearily normal individuals - “those who follow a common rule.” Their goals were to fit in, do good, and be liked. Apparently they would grow up to become part of the “great silent majority” that Nixon infamously pandered to.

As Dr Ghaemi points out in his book, Dr Grinker’s homoclites represented the norm (a statistical average) and normal (an absence of illness), but hardly an ideal.

Which brings us to the $64,000 question ($523,412.54, adjusting for inflation): When the chips are down, would you truly want one of Grinker’s homoclites as your President or Prime Minister?

Or would you would feel more comfortable with someone who had been temporarily expelled from school, such as JFK?

Basically, Dr Ghaemi is validating what many of us have felt all our lives, namely: those of us who are not normal have no desire to become normal. True, we don’t want to be severely depressed or manic, either, or for that matter overly anxious or cognitively impaired or just plain feel miserable inside our own skins. We want to be better, to be ourselves.

But normal? No way, normal sucks.

I’ve related numerous times here on Knowledge is Necessity a knock-me-over-with-a-feather moment from a grand rounds I delivered three years ago to a psychiatric facility in Princeton, NJ, but it bears retelling and reinterpretation. Obviously, the individuals I was addressing were considerably smarter than your average homoclite. Nevertheless, we are living in a homoclite culture that apotheosizes normal. Just about everyone is in on the act. Just about everyone believes in the myth.

So here I was, trying to get through to a bunch of what I now know to be accomplished homoclites.

"Keep in mind," I said, "a lot of us view the world through the eyes of artists and poets and visionaries and mystics. Not to mention through the eyes of highly successful professionals and entrepreneurs. We don't want to be like you."

It was as if I had let rip a roof-rattler and everyone was too polite to laugh. Then I blurted out: “To me, you all have flat affect.”

Kelvin grade frozen stony cold silence.

Suffice to say, my talk was a disaster.

I naturally assumed that I had been wasting my time trying to get through to people heavily invested in the myth of normal. But, after reading Ghaemi’s book, maybe something else was going on, as well. Maybe these individuals suffered basic deficits in the empathy department.

There is a biological component to empathy, but a lot of it has to do with getting blindsided out of nowhere by whatever life has decided to throw at you. Picking up from Ghaemi’s account:

Franklin Roosevelt had a glorious future ahead as a homoclite golden boy. Mind you, FDR was no dullard. Quite the opposite. According to Ghaemi, FDR was an “omnivore and an innovator,” with certain manic tendencies consistent with a “hyperthymic” temperament. But, “until 1921, Franklin Roosevelt had led a charmed life.”

Everything changed at age 39, when he was felled with polio. He returned to public life three years later a different man. According to longtime friend and political associate, Frances Perkins, recounted by Ghaemi, “an untried flippant young man” underwent “a spiritual transformation,” emerging “with humility of spirit and with a deeper philosophy.”

Years later, Eleanor Roosevelt would remark: “He certainly would have been President, but a different President.”

So here I was, in Princeton, talking to a bunch of mental health professionals who couldn’t see the merit in even “a little bit” crazy, who could not even relate to the possibility that a good many of us do not want to be like them. That, to people like us, normal sucks.

Naturally, I could understand why they wouldn’t want to be like me. But could they not, at least, validate my creativity and other traits the way I value their stability? Could they not acknowledge that maybe they, too, could benefit from some of my strange gifts?

Introspection, enthusiasm ... empathy?


Gina Pera said...

I think I'm missing the point of that study. So they took a group of "normal" people. Who would expect much from people in the average range of everything? Why didn't they take people in the average range of mental health but in the high range of intelligence, achievement, etc. I don't believe those people don't exist.

Also ask what is "normal" (or "average," rather) for people with manic-depression, ADHD, or whatever you choose. Then compare those "average people with manic-depression" to the average "normal".

That's the only way to make a fair comparison, IMHO. But maybe I'm missing something.

Gina Pera said...

"Maybe these individuals suffered basic deficits in the empathy department. "

Really? You told them they were dull and they didn't empathize with your perspective? lol!

butterflywings said...

I read the first instalment, and this post, with interest.
I find Ghaemi's theory interesting, but ultimately I don't think mental illness is helpful.
I agree that 'normal' people aren't likely to achieve much in life, and not everyone wants to - and that's a good thing, as society needs more Joe and Josie Averages than leaders/ visionaries, after all. Those who become leaders are bound to be different - in terms of personality traits, intellect, and so on - from the norm. I just think deviation from 'normal' isn't the same thing as having a mental health issue. Ghaemi seems to confuse the two a bit - e.g. diagnosing ex US presidents who he never met as 'hyperthymic', well, yes, they may have had somewhat higher than average energy but that's completely different from mania and not a mental health issue whereas mania is. Real hypomania or mania is often disabling and unpleasant, and the 'creative and brilliant genius' label really irks me. For every Churchill, Lincoln, Stephen Fry, whoever, there are a hundred people with bipolar/ depression who are severely incapacitated. Note that those who achieve 'greatness' are largely white, middle to upper-class, straight men. They succeeded *in spite* of their mental health issues, not because of them.

John McManamy said...

Hey, Butterflywings. Very glad to have you in the discussion. Your energy point is very interesting. The DSM-5 will be including increased energy as one of its criteria for mania and hypomania. But this alone is no indicator of mania or hypomania.

I've experienced the disabling side of mania, and hypomania is often no picnic for me, either. And I've seen the incapacitated people in support groups and elsewhere.

But I've also noticed a good many of those with bipolar seem to possess a spark and sparkle you don't often see in the general population. We're so into looking at the pathology that we fail to recognize paradoxical benefits.

As for deviation from normal - absolutely. Thanks for keeping us honest.

As for Joe Average - yep. We don't want all of society to be like us. We need all those average people who don't rock the boat. So the reality is we will always be outsiders looking how to fit in.

Very interesting discussion. It gets right to the heart of who we are. :)

Al said...

I also question how "normal" these people really were, if Grinker could only find 65 of them in a sample of 343. I did the math (even though this is in contravention of many international humanitarian treaties) and that works out to 18%. Hardly a moral "majority".

I couldn't easily find any references to Grinker's work, so I don't know if he looking for a bell curve or what ... but if he was, the "norm" is supposed to be where most people cluster, right?

Anonymous said...

Normal humanity is so predictable not that it is bad or good but they do get stuck in a rut in life. Why else are they so easily maniuplated by media/leaders/corporations. It is like they quit thinking for themselves & will buy into anything that allows them to continue to be asleep at the wheel of life. Nothing original just let me buy your product or be part of your group & let me know the rules I can live by. See I wear your clothes/drive your car ...I am in your club....I am a Republican/Democrat/vegan/Catholic/Doctor or fill in the blanks. It is the old us vs them herd mentality...Don't venture to far off..Fear keeping you in line. These are the rules to live by..then we accept you.
I am all to well of the gifts & dangers of MD but I have gained empathy for others thru my suffering in life. That is a gift. We seem to drop the illusion of a wall that seperates us from our fellow man.

Living each moment with each unique gifts it can give you is being awake. By living by the rote/rules is someone asleep at the wheel of life. I choose to be awake. Even at the heights & depths of MD I knew I was alive. Like a shoot coming from the darkness of the ground struggling for the light. Life can be about struggle. It tempers us & makes us stronger.
I agree about the "sparkle" thing. I have noticed it too. I believe it is the gift of the spirit. It is your prize for being present in your life.

I loved the book & tell everyone I know about it.

Though a word about the common man from Mark Twain...(don't quote me this is from memory) God must love the common man cause he made so many of them....

I do love the common man. I understand him I have been him or at least tried to fit in with him. I tried to live his life. I do not judge him nor am I better than him. I am "Justawatchingit"