Yale neuroscientists debunked the idea that anyone is “normal”

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Don’t you wish everyone would just act more normal, like you? I know I do.

But normal is a relative state that depends on time, place, and circumstance. There’s no one right way to be a human, and that applies to mental as well as physical states. That’s why neuroscientists are advocating for more recognition of the bizarre normalcy of all complex humans in psychiatry—an argument that can help all of us take a bigger-picture view.

A new study published in Trends in Cognitive Science on Feb. 20 debunks the myth of normalcy in people and animals. “The Myth of Optimality in Clinical Neuroscience” (paywall), by Avram Holmes and Lauren Patrick of the Yale University psychology department, uses evolution to show that uniformity in our brains is totally abnormal. What’s much more common in life, during its 3.5 billion years of evolving existence on Earth, is range and change, variety in and among creatures and habitats.

Evolution is about crafty adaptability, changing with conditions and times. Because all things, from trees to families, countries, and continents, are in a state of flux, the only constant state is a constantly transforming one. This means that any one behavior or condition may seem good or bad, appropriate or inappropriate, depending on the context.

That applies to psychiatric conditions, too. Yale researchers analyzed the range of beaks in a single bird species, among many other evolutionary variations—including a seemingly infinite number of human behaviors which may be appropriate and indeed ideal at any given moment. They conclude:

[T]here is no universally optimal profile of brain functioning. The evolutionary forces that shape our species select for a staggering diversity of human behaviors […] We propose that, instead of examining behaviors in isolation, psychiatric illnesses can be best understood through the study of domains of functioning and associated [complex] patterns of variation across distributed brain systems.

In other words, trying to define people one way from a psychiatric perspective is a failure of imagination and opportunity, which hobbles people rather than empowering them to inhabit their full selves. Classic psychiatry categorizes people in limiting, linear ways, while the world is inherently wide-ranging, according to the researchers.

They propose instead that each individual be assessed and understood singularly from a psychiatric perspective, but according to a wide range of fluctuating behaviors and tendencies.

This is a quantum approach to psychiatry, rather than the classic binary approach that offers only two options, ones and zeros. In computing terms, the quantum approach considers countless entangled factors in tandem to solve a single problem in an extremely sophisticated way, while the digital computer thinks in “ones” and “zeros,” and presents solutions that are the same old problems. This more complicated system doesn’t attempt to know individual bits of random information in isolation, but to understand all as a whole.

For patients, the binary approach can lead to unfair treatment, as a psychiatrist takes a narrow understanding of mental health and attempts to make a person conform to a disease. Instead of abandoning categories for patients altogether, the Yale researchers say psychiatrists should refine them but see a bigger picture, and be more creative in their approach to categorization. A person wouldn’t have attention deficit disorder necessarily as a diagnosis but a psychiatrist might instead examine the settings in which the tendency to distraction is healthy instead of harmful.

Quartz asked Holmes, the lead researcher on the study, how he might explain the approach to psychiatry to a person at a party. He replied:

The point we argue is that there is no universal, unconditionally optimal pattern of brain structure or function. So the border separating health from disease cannot be cleanly drawn through a single behavior or aspect of brain function. In isolation, any given behavioral, psychological, or neurobiological trait is typically neither good nor bad. Rather, the context a person is in, their age, social network, and environment, can have a huge influence on the costs and benefits of particular traits.

Holmes stresses that it’s important for people to seek psychiatric treatment when they’re struggling. The discipline’s current approach to mental health may be insufficiently complex, but caring and empathetic psychiatrists can and do help to alleviate people’s suffering. He writes, “If an individual is suffering and would benefit from seeking treatment, then I would encourage them to do so.”

By Ephrat LivniMarch 15, 2018