Am I “Normal?”

One of the most common questions I’m asked by therapy and testing clients is “Am I normal?” It’s a fair question, and it makes sense that some people view psychologists as the people trained to give a solid answer. After all, one of the core educational requirements of anyone seeking a graduate degree in psychology is a course in “Abnormal Psychology.” It can certainly be fascinating to learn about “outliers” in any human trait—intelligence, athleticism, narcissism, and so forth. Plus, in order to accurately assess and diagnose, we need a framework for organizing whatever it is we are assessing and diagnosing. As such, the foundation of our field for the last century has been rooted in “mental illness” being just that—a diagnosis or label, assigned to people whose presentations are “not normal.” So I get why this is the burning question.

“Normal” in 2017 is more elusive than ever. With technology at our fingertips, we ask Google, Wikipedia, and WebMD to weigh in. Social media has perhaps been most influential, taking the “am I normal?” question and providing “answers” by showing us what “everyone else” is doing with their lives. What does a “normal” body look like? A “normal” family? A “normal” person’s Saturday night? Consult social media, where you can decide if you measure up to the curated online images of people popping up in your newsfeed. For some people, it’s easy to feel lame and unsuccessful when it’s “normal” to censor ourselves and only show the public the highlights reel. For others, it’s a constant competition to set the new standard. I wonder what would change if everyone knew how much everyone else was asking whether “it’s normal to [fill in the blank]?” Maybe we’d have more tolerance for the full spectrum of our daily experiences if we could accept that “normal” doesn’t exist.

Perceptions, thoughts, feelings, sensations, and memories are subjective. They are often driven by context and filtered through the lenses we’ve developed through life experience. So what’s “normal” in one context may not be seen as normal in another. Walking down the sidewalk with one’s nose to the ground, sniffing for discarded food scraps = unusual for a human, “normal” for a dog. Sucking one’s thumb = unusual for a 45-year-old, “normal” for a 2-year-old. However, context isn’t always as clear as one’s species or age. Is it “cautious and smart” to lock and then double-check the locks on your doors and windows at night, or is it “paranoid and obsessive” to do so? It depends.

It’s “normal” (natural?) to be curious about whether our experiences and behaviors can be considered appropriate, acceptable, or healthy. But who is the authority on what is considered appropriate, acceptable, or healthy? Psychologists? We’re people too! I’m not the authority on “normal” just because I can tell you if you match up to an agreed-upon set of criteria published in a scientific manual. The reality is that you are the authority on yourself, so only you can answer whether your experience is adaptive or not.

For example, anxiety is “normal.” In fact, it’s a human necessity. It keeps us alert to danger and motivated to complete tasks. Without any anxiety, we have no urgency to get anything done. With too much anxiety, however, we become too overwhelmed to be productive. Finding that “sweet spot” of optimal anxiety for optimal performance on top of the inverted “U” illustrated by the Yerkes-Dodson Law  is the key to success. That sweet spot, however, is subjective to the individual experiencing it.

Current research shows that mental “illness” might be more of the “norm” than the outlier. The Dunedin Study in New Zealand has followed over 1,000 people from birth and over the course of their lives for the past 40 years, assessing them every few years to look at various health and mental health conditions. The most recent “check in” with study participants took place when they were 38-years-old. So far, only 17 percent of the sample has never met any criteria for a psychiatric disorder at any time in the study’s assessment points. This means that at some point in your life, it is likely that you meet criteria for a psychiatric diagnosis (most commonly something like depression, anxiety, an adjustment disorder, or substance abuse). While of course no single study can be generalized to reflect the whole world’s population, it gives us some pretty solid data.

Given these findings, we could argue that it’s “normal” to experience depression at some point in one’s life, just like it’s “normal” to get the flu or break a bone at some point in life. Whether your symptoms warrant treatment depends on how the symptoms are interfering with your life. Everything falls on a spectrum; just as there is a difference between bumping your head and bumping your head with such force that it’s deemed a concussion, there is a difference between feeling a flash of anxiety before a big presentation and feeling such debilitating anxiety that you cannot speak.

The newest version of the Diagnostic and Statistic Manual of Mental Disorders (DSM5), which mental health professionals use for making clinical diagnoses, has shifted towards a more dimensional approach that matches this concept of everything falling along a spectrum. Hopefully, in future editions, it will move even further away from categorizing people as “normal” vs. “abnormal” and help us remove the stigma from these diagnoses, especially since most diagnoses can be temporary. So is it “normal” to struggle at some point, and to have symptoms intense enough to meet criteria for a diagnosis? Absolutely. It’s part of being human.

Maybe we can let go of the need to know if we are “normal” and instead ask ourselves, “does this work for me?” or “is being this way helping me live a meaningful life?” When I first meet with someone seeking therapy, I ask them the “miracle question,” some variation of the following: “If I waved a magic wand and you walked out of here today completely cured of your [depression, anxiety, painful trauma memories, addiction, etc.], what would be different about your life? What would you be able to do?” Usually, the answer has something to do with more meaningful relationships with loved ones, a rewarding job, more energy, etc. Those answers become our treatment goals. If you’re able to move towards your values, the things that truly matter to you, then isn’t that more important than knowing if you’re “normal” by someone else’s standards?

Why is language so trippy?

Have you ever done that thing where you start saying a word over and over and over again until it sounds sort of singsongy and you forget what it even means? When I was little, I used to do this a lot  with random “simple” words, like “awhile” and “because.” Yes, I was apparently born a word nerd. I don’t recommend doing it in public unless you really want to annoy everyone around you, but try it out and you’ll see just how nonsensical and strange words become when you repeat them. Language is trippy, and the unconscious process we have for interpreting language can be fucking weird. Think about how right now, your eyes are automatically scanning the shapes on this screen and making sense of the shapes based on how they are structured and combined with one another. Really, stop reading and think about that…

It’s kind of mind-blowing, right? We have these intricate webs of connections between words and what they represent, and our minds are constantly on autopilot interpreting those connections. It’s the process that lets us communicate with each other, and the reason we can remember something that happened years ago. We do this without being guided to do it. Okay actually, we are guided early on, but it quickly becomes second nature.   While we aren’t born with the ability to read written language, we are born with innate “reading” abilities that then get shaped and developed as ways for us to survive in a language-based world.

Unless you’re a word nerd like me who grew up thinking words and letters were just as fun to play with as Legos and dolls, you probably don’t notice language doing its thing on a regular basis. If you start to think about it and notice yourself thinking in words, and notice the associations you make with whatever the words bring up for you mentally, you get sucked into kind of this “meta” space.

The Lemon Exercise is a great way to illustrate the power of verbal associations and sensory experiences. Close your eyes and picture a lemon.  The bright yellow color of it, the bumpy, textured peel, the round, footballish shape… imagine slicing into it and noticing the way it looks, the pinwheel design with seeds in the middle, picture the juice dripping onto your fingers as you hold a slice, inhaling the fresh, citrusy lemon scent… now imagine yourself putting the slice in your mouth, feeling your mouth salivate as the sweet, tangy tartness of the lemon hits your tongue…

Without the presence of a physical lemon, you can conjure up a “lemon reaction” in your brain and body just by visualizing its properties. If you had never heard the word lemon or seen a lemon, let alone tasted a lemon, it would literally just be a sound to you when you heard the word, and this exercise wouldn’t be possible. That’s why foreign languages sound so, well, foreign (duh); we don’t have any context for interpreting the sounds we’re hearing until we attach a meaning to those sounds. Collectively, we give words meanings, and then based on our life experiences, those meanings become implicitly fine-tuned to the degree that they can even evoke strong reactions inside of us without us realizing it.

What does this have to do with mindfulness? EVERYTHING. I like to use my little repeating game with clients who have a hard time recognizing that thoughts are just words in the brain. Usually, the culprit is a thought along the lines of “I’m worthless/ not good enough/ not smart enough/ can’t do it/ never going to get what I want.” Most of the time, we don’t notice our thoughts because they act like a continuous inner dialogue, our brain’s voice sort of narrating things as we live life. We don’t usually stop to reflect on this narration– we just take it at face value, as a fact of life, and keep going on with our days. This isn’t always a big deal, but it can get messy when our brain’s little narrator voice is saying stuff that’s bullying, judgmental, or not serving us in some other critical way.

When we have a particularly troubling or unpleasant thought, we sometimes get “hooked” on it.  For many of us, it’s usually fears, worries, areas of insecurity, or that growing to-do list. When thoughts of this flavor come up and start to bug us, that’s where the mindful pause is helpful. If you can slow down and go to that trippy “meta” place where you notice yourself interpreting the words your brain is saying to you, you can step away from all of those subconscious associations between words and their meanings and instead see them as just words.

This is an example of what happens when a thought is mindless: the brain-voice says “You look stupid today,” and you instantly, automatically react, sometimes in the form of a flurry of additional thoughts (“ugh, I always look like such a mess,” and “I hope I don’t run into anyone I know”), feelings (self-conscious, embarrassed), and/or memories (of a time when you felt more confident in your appearance, for example).  Here is what happens when a thought is mindful: the brain voice says “You look stupid today,” and we start to react but then notice what we’re doing and SLOW DOWN for a second. Maybe you say back, “that’s an interesting thing to say, brain, what’s up with that?” or maybe “that’s one thought, what’s another one? What else do you have for me?” And see if the brain gives you anything else. If the brain voice doesn’t come up with any new material, we can start to more intentionally repeat it over and over until it loses meaning. If you say “I look stupid” enough times, you realize you’re just saying words, and okay, so what does it really mean then, if the words are true? How can you be SURE? Why do you care? What do you want to DO about it?

As a side note, mindlessness (and mindFULness) applies similarly to how we experience emotions and behaviors, but I will save that little ramble-fest for another time.

Given all of this, that old playground chant of “sticks and stones may break my bones, but words can never hurt me” seems incomplete. Of course words can be hurtful, who are we kidding here? But only in certain contexts.  Stupid is just a word. And words are just sounds that we put together to mean something. But when we slow down, we don’t have to mindlessly go with those meanings. Perhaps we should be teaching kids that sticks and stones may break my bones but words can never hurt me because I choose how much I buy into their intended meaning.  Less catchy, but more accurate! What does your brain-voice say about that?