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The Idiom of Normality

Presented in part at the Inter-university Neuroscience and Mental Health Conference, University of Sydney, 30 September 2014 and also at Disorder, The University of Sydney Anthropology Symposium, 4-5 November 2014.

Paul Mason

on 3 November 2014

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Transcript of The Idiom of Normality

Anthropological concepts &
Scientific thinking
At the centre of professional approaches to mental health and human performance, the brain holds a magnetic pull over both specialists and the general public. Today, more mental health conditions are diagnosed than science knows how to redress. Putting the brain at the centre of mental health approaches has significant social consequences and drives an industry that capitalises upon culturally constructed notions of normality and abnormality. While acknowledging the mental health practitioners who deliver empowering services to vulnerable populations, people working in the brain sciences are also obliged to critique a neurocentric worldview that encourages brain function to be conceptualised according to a reductionist scientific discourse of normalcy and degeneracy. This presentation will debunk our commonly held notions about normality by looking at the history of this misappropriated term. After debunking the myth of normality, this presentation will explore the heterogeneous construction of human diversity and call for holistic models of human experience that embrace the integration of variable intersecting factors at multiple levels of complexity. In recent years there has been a strong push towards integrative personalised approaches to mental health. With some methodological and interpretative issues remaining to be resolved, integrative analyses centering on the individual are proving fruitful with a multi-pronged treatment approach being promoted where counsellors, social workers, and social policy makers among others can all view their engagement as interlinked, with no particular agent offering a complete solution on their own. Researchers, clinicians, and educators, benefitting from the ongoing commercialisation of the body, are putting the individual at the nucleus of critical inquiry. With the individual at the centre, reductionism is defied by situating the person as a relational being whose intersubjectivity, life history, and cultural experience are variously factored in all their splendour and complexity.
The Idiom of Normality
Paul Mason
What is Normal?
The normal is what you find but rarely. The normal is an ideal. It is a picture that one fabricates of the average characteristics of men, and to find them all in a single man is hardly to be expected.
Somerset Maugham, 1938
For anywhere up to 52 days, psychiatric staff in 12 different medical institutions did not detect 'normal' behaviour among 8 pseudopatients who falsified existential auditory hallucinations in order to be admitted but did not subsequently report further hallucinations. They behaved sanely and cooperatively during their stay.

Rosenhan, D.L. 1973. On Being Sane in Insane Places. Science, 179(4070), 250-258.
Tony faked a mental disorder to escape a 5-year prison sentence. He ended up spending 12 years in a psychiatric award.
a good Buddhist
Saintly trance
Tanya Luhrmann of Stanford pre­senting about "Hearing voices in Accra and Chennai: How Culture Makes a Difference to Psychiatric Experience" at the 5th inter­dis­ci­pli­nary con­fer­ence on Cul­ture, Mind, and Brain: Emerg­ing Con­cepts, Meth­ods, Appli­ca­tions hosted by the Foundation for Psychocultural Research on 20 Octo­ber 2012.
Context Confers Meaning
Normality is a term which recurs with disturbing frequency in the writings of psychologists, psychiatrists, psycholoanalysts, sociologists, and other people concerned with human behaviour.
H.J. Eysenck, 1953

"The average man does not exist. The average applies to a set of data and not to an individual and if the average man could exist he would be such an odd specimen that by his very uniqueness he would deny his own title.”
William John Reichmann (1964, 121)
William Petty 1623-1687
Political Arithmetic
Gottfried Achenwall 1719-1772
- a term of statecraft first coined in 1749 to refer to systematic methods of summarising, in words, a nation's strength, in terms of its natural, economic, military, and human resources.
- the word entered the English language in 1791 and became used in the branch of mathematics concerned with proability and causal inference in the early 20th Century
William Whewell (1794-1866)
In the 1830s, natural philosophers started to be called “scientists”, a term coined by William Whewell.
L'homme moyene
Adolphe Quetelet 1796-1874
Using a mathematical methods from astronomy, Quetelet erroneously argued that the distribution of a population's characteristics served as a guide to its ideal value, one obscured by the imperfect variation of individuals.
Statisticians say "mean" things.
What is the "mean"?
The “mean” was a misappropriation of mathematical methods from astronomy by statisticians trying to characterise human populations.
A planet is a single moving object.
A human population is composed of a collection of discrete individuals.
In the 1840s, a carpentry term for upright and perpendicular, the “norm”, became the root for a constellation of words to refer to the common type or standard.
Lambert Adolphe Jacques Quételet believed that the attributes of the average individual represented "all which is grand, beautiful, and excellent" (1842).
Karl Pearson introduced the term "standard deviation".
Karl Pearson 1857-1937
The application of numerical approaches and statistical analyses to large groups of individuals, including the idea of the "normal" - in the sense of average - individual, is essential if a concept of "population" is to have political applicability.

Margaret Lock and Vinh-Kim Nguyen, 2010
An Anthropology of Biomedicine, Wiley-Blackwell.
once denoted a flag raised on a pole as a rallying point, but the "standhard" has become a metaphor for the values that a group hold up and aspire to and against which a person is measured
Battle Standar
"In tackling the myth of normal, I am talking about our overemphasis on constraining the range of human variation into too narrow a band—mistaking “average” for a value statement, and forgetting that it is merely a statistical description."

Augustin Fuentes, (2014) Why Normal is a Myth, Psychology Today, March 17.
Popularising the sentiments of his nineteenth century contemporaries, Max Nordau, formerly Max Sudfeld, believed that degeneration was a mental and social disease
Max Nordau 1848-1923
Augustin Fuentes on height:

"If you line up all males and female adults in a population, there is usually about a 70 percent overlap in height—meaning that the statistically average male is taller than the statically average female. However, if you actually go out and select thousands of individual people at random in this population and just look at their heights in the absence of any other data, you are going to be able to accurately determine their sex by their height alone only about 30 percent of the time. Yes, the tallest are likely to be men and the shortest, women—but this does not get you anywhere near 100 percent of the actual variation. This means that being a tall woman or a short man, while statistically out of the norm, is not by any means uncharacteristic—or abnormal. It is a regular part of the distribution of variation. Tall women and short men are normal."

Augustin Fuentes, (2014) Why Normal is a Myth, Psychology Today, March 17.
"Weight is even more complicated. Currently we use BMI (the relationship of height to weight) as a measure of overall health. This assumes that there are easily identifiable, and normal, relationships between height and weight in regards to being a healthy human. But weight and health, while related, is not a simple relationship, and BMI does not differentiate between a body builder and a couch potato whose height and weight may be the same but for very different reasons. It is very apparent that while BMI does work for those at the very extreme of the height/weight relationship range, it is not a great measure of health in most of its range".

Augustin Fuentes, (2014) Why Normal is a Myth,
Psychology Today, March 17.
"If we are getting “normal” so wrong for things as easy to measure and understand as height and weight, what about things like gender identity, sociability, imaginative interests, etc.?"

Augustin Fuentes, (2014) Why Normal is a Myth, Psychology Today, March 17.
Speaking of the Nuer people of Southern Sudan, E.E. Evans Pritchard wrote in 1940 that "their social idiom is a bovine idiom".
Due to its association with eugenics in the interwar years and the Third Reich's "Final Solution", most mainstream biologists distanced themselves from degeneration theory. In this scientific cultural climate, George Gamow's contribution to genetics was largely ignored or at best hidden deep in the methods sections of genetics research articles.
In the brain sciences...
Degeneration is a term used only for neurological conditions where a scientific explanation is absent.

Most current neurology textbooks do not include degeneration as a nosological term

The largest book on Neurodegenerative diseases does not define these illnesses
(Calne 1994)

In the brain sciences...
The most accepted definition for neurodegenerative conditions enumerated a group of diseases united only by the gradually progressive disintegration of part (or systems) of the nervous system.
(Bermejo-Pareja 2011:11; Pryse-Phillips 1995:602)
The days of thinking about degeneration as negative dilapidation are numbered...
In 20th century physics, degeneracy refers to different stationary states corresponding to the same energy level. Physicist, George Gamow saw the genetic code as degenerate: many different nucleotide triplets coding for single amino acids.
George Gamow 1904-1968
“Degeneracy is the ability of different structures to yield the same output.”

Gerald Maurice Edelman, BioEssays, 2004
Gerald Edelman (1929-2014)
e.g. Pens and pencils
Degenerate structure-function mapping is crucial for understanding the nature of brain networks.

Park, H., & Friston, K. (2013) Structural and Functional Brain Networks: From Connections to Cognition. Science, 342, 579.
Neurological lesions that appear to have little effect upon behaviour within familiar contexts reveal the presence of degeneracy in the brain.

Tononi, G., Sporns, O. & Edelman, G.M. 1999. Measures of degeneracy and redundancy in biological networks. Proceedings of the National Academy of Sciences USA, 96, 3257-3262.

Different populations of neurons in response to identical external stimuli can produce similar behavioural responses.

Noppeney, U., Friston, K.J., Price, C.J. 2004. Degenerate neuronal systems sustaining cognitive functions. Journal of Anatomy, 205, 433-442.
Brodmann areas
Rajkowska, G., Goldman-Rakic, P.S. (1995) Cytoarchitectonic Definition of Prefrontal Areas in the Normal Human Cortex: II. Variability in Locations of Areas 9 and 46 and Relationship to the Talairach Coordinate System, Cerebral Cortex, 5, 323-337

Intersubject variability in the cytoarchitectonic profile of cortical areas 9 and 46. Overlap in the plots of five superimposed left-hemisphere reconstructions is indicated by the level of shading. Cortical territory occupied by area 9 or area 46 in all five individual brains is filled in black.
Brain sciences
Pulmonary science
Sports science
Cognitive neuroscience
Molecular physiology
Cancer Research
Language evolution studies
Population dynamics
Cellular physiology
Thank you
Travel Grant, Archive Research, Leiden University
The Australia-Netherlands Research Collaboration (ANRC)
Maleszka, R., Mason, P.H., and Barron, A.B. (2014)
Epigenomics and the concept of degeneracy in biological systems,
Briefings in Functional Genomics, 13 (3), 191-202.
Somerset Maugham 1874-1965
Deacon, T.W. A role for relaxed selection in the evolution of the language capacity, Proc Natl Acad Sci USA 2010, 107, 9000-9006.
Downey, G. 2012. Cultural Variation in Rugby Skills: A preliminary neuroanthropological report. Annals of Anthropological Practice, 36(1), 26-44.
Edelman, G.M. Synthetic neural modeling and brain-based devices. Biological Theory: Integrating Development, Evolution and Cognition 2006, 1, 8-9.
Edelman, G.M.; Gally, J.A. Degeneracy and complexity in biological systems. Proc Natl Acad Sci USA 2001, 98, 13763-13768.
Figdor, C. Neuroscience and the multiple realization of cognitive functions. Philosophy and Science 2010, 77, 419-456.
Friston, K.; Price, C.J. Degeneracy and redundancy in cognitive anatomy. Trends in Cognitive Science 2003, 7, 151-152.
Kelso, J.A.S. Multistability and metastability: understanding dynamic coordination in the brain, Philosophical Transactions of the Royal Society B, 2012, 367, 906-918.
Komar, J.; Chollet, D.; Seifert, L. How the Level of Environmental Constraint Supports Neurobiological Degeneracy, In: Studies in Perception and Action XII; Davis, T.J.; Passos, P.; Dicks, M.; Weast-Knapp, J.A., Eds.; Psychology Press, 2013; pp. 14-17.
Leonardo, A. Degenerate coding in neural systems. Journal of Comparative Physiology A: Neuroethology, Sensory, Neural, and Behavioral Physiology 2005, 191, 995–1010.
Levine, B. Brain imaging and neuropsychology: scope, limitations, and implications for degeneracy in neural systems. Neuropsychological Rehabilitation 2004, 14, 473-476.
Maleszka, R., Mason, P.H., and Barron, A.B. (2014) Epigenomics and the concept of degeneracy in biological systems, Briefings in Functional Genomics, 13 (3), 191-202. Doi:10.1093/bfgp/elt050
Mason, P.H. (2014) Degeneracy: Demystifying and destigmatizing a core concept in systems biology. Complexity. doi: 10.1002/cplx.21534
Mason, P.H. Degeneracy at multiple levels of complexity. Biological Theory 2010, 5, 277-288.
Mitchell, K.J. The genetics of brain wiring: From Molecule to Mind. PLoS Biology 2007, 5, e113.
Noppeney, U.; Friston, K.J.; Price, C.J. Degenerate neuronal systems sustaining cognitive functions. Journal of Anatomy 2004, 205, 433-442.
Park, H., & Friston, K. (2013) Structural and Functional Brain Networks: From Connections to Cognition. Science, 342, 579.
Price, C.J.; Friston, K.J. Degeneracy and cognitive anatomy. Trends in Cognitive Science 2002, 6, 416-421.
Tononi, G.; Sporns, O.; Edelman, G.M. Measures of degeneracy and redundancy in biological networks, Proc Natl Acad Sci USA 1999, 96, 3257–3262.
Rubinov M, Sporns O. 2011, “Weight-conserving characterization of complex functional brain networks.” Neuroimage 56(4):2068-79
Sporns, O. 2011. Networks of the Brain. MIT Press.
Whitacre, J.; Atamas, S.P. Degeneracy allows for both apparent homogeneity and diversification in populations. Biosystems 2012, 110, 34-42.
Whitacre, J. Degeneracy: A link between evolvability, robustness complexity in biological systems. Theoretical Biology and Medical Modelling 2010, 7, 6.
Whitacre, J.; Bender, A. Degeneracy: a design principle for achieving robustness and evolvability. Journal of Theoretical Biology 2010, 263, 143–153.

Despite recent resurgence in interest,
why is degeneracy being largely overlooked?
1. Hidden in plain view

2. The word 'degeneracy' is misleading given the history of 'degeneration theory'

3. A reductionist bias in science.
The central idiom of our society
may well be the idiom of ITY
Ernest Gellner believed that 'a common idiom' is necessary to allow individuals to negotiate their position in society.
Ernest Gellner (1925-1995)
A central idiom
Despite the shortcomings of a functionalist argument, a common idiom:
can be pervasive and widespread.
but should not be taken to the point of essentialism
Dirt is
Matter out of place
(Mary Douglas 1966)
Junk DNA
What is it about scientific thinking
that leads us to think of certain biological substances as Junk?
Georges Canguilhem (1904-1995)
"Le concept de norme est un concept original qui ne se laisse pas, en physiologie plus qu'ailleurs, réduire à un concept objectivement déterminable par des méthodes scientifiques. Il n'y a donc pas, à proprement parler, de science biologique du normal. Il y a une science des situations et des conditions biologiques dites normales."

"The concept of normal is an invented concept that cannot be reduced in physiology or elsewhere, to a concept objectively determinable by scientific methods. Thus strictly speaking there is no biological science of the normal. There is a science of biological situations and conditions called normal."

Domínguez et al. (2013) PLoS ONE
Margaret Lock 2013
Joseph Dumit
"But Eugenists really have something better to propose.
No one can study the pedigrees of pathological
states, insanity, mental defect, albinism, &c., collected by
our Laboratory, without being struck by the large
proportion of tuberculous members—occasionally the
tuberculous man is a brilliant member of our race—but
the bulk of the tuberculous belong to stocks which we
want ab initio to discourage. Everything which tends
to check the multiplication of the unfit, to emphasize the
fertility of the physically and mentally healthy, will pro
tanto aid Nature's method of reducing the phthisical
death-rate. That is what the Eugenist proclaims as
the ' better thing to do ', and 1,500,000 pounds spent in
encouraging healthy parentage would do more than the
establishment of a sanatorium in every township.

Karl Pearson (1912) Tuberculosis, Heredity and Environment. London: Dulau & Co. (pp 45-46)
Cerebrospinal fluid
"TB should be
"...the customary modern normal-abnormal categories and our conclusions regarding them. In how far are such categories culturally determined, or in how far can we with assurance regard them as absolute? In how far can we regard inability to function socially as diagnostic of abnormality, or in how far is it necessary to regard this as a function of the culture? As a matter of fact, one of the most striking facts that emerge from a study of widely varying cultures is the ease with which our abnormals function in other cultures."

Ruth Benedict 1934, p. 60.
The problems that have arisen relate to...
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