Notes for class discussion

Walter vom Saal


Disclaimer: the points made here are intended to stimulate critical thinking.  Not all psychologists would agree with the approach taken in this lecture.   Nothing here is meant to diminish the fact that mental illness is a serious problem, and needs to be taken seriously. 




One view of “abnormal behavior” (or “mental illness”) is that it represents a distinct, unique state and that there is a sharp distinction (or dichotomy) between mental illness and mental health.


Another view is that mental illness and mental health are on a continuum.  According to this view, there is a broad range of behaviors that could be labeled as “mental health” or “mental illness” in varying degrees, and these behaviors may vary across individuals, across time for any individual, and across situations.  [This view can be related to earlier class discussions about whether there is such a thing as “personality” or whether there are just individual behaviors that are “situational.”   It can also be related to earlier discussions about whether there is such a thing as generalized “intelligence” or whether intelligence, also, is dependent on different skills, different abilities, and different measurement approaches.]


The chart below illustrates these two different approaches:



    - two classes or categories

    - no overlap

    - sharp distinction



    - broad range

    - varying degrees

    - extremes with intermediate possibilities


To illustrate the view that mental illness is best viewed as a continuum, we made the following arguments:

- mental illness (abnormal behavior) represents one end of a continuum, not a completely separate state that strikes some individuals and not others.

- there is no sharp distinction between mental illness and mental health.

- mental illness (abnormal behavior) is often an extreme form of things we all experience.


Class discussions of ways we have experienced various kinds of “abnormal behavior” in everyday life have generated the following examples:


1. Compulsions.  Repeated, unwanted acts.

a. any habit you have that doesn’t make sense.

b. socially acceptable (even trained) compulsions: daily shower, bath, wash hands before meal, brush teeth.

c. rituals carried out as a child:

- count sidewalk cracks while walking to school.

- skip cracks.

- count fence posts while walking to school.

- “I had to kick the curbs while walking to school; one day I realized I had missed one and I ran back and started all over.”

d. bedtime rituals as a child: say goodnight; say prayers; kiss goodnight.

e. check the door lock repeatedly, even though you know you just checked it.

f. check the alarm clock setting repeatedly.

g. woman who drove back home to line up shades in windows.

h. repeatedly check to see if stove is turned off.

i. must have dresser lined up, neat, symmetrical before going to bed.

j. men: check that your fly is zipped.

k. check pants for wallet, keys.

l. eating rituals.  Some people have to eat all vegetables before meat.  Others have different patterns they have to follow.

m. “I have to use my knife in a certain way (hold my fork in a certain way).”

n. cigarette smoking.  coffee.  cocktails.  drinking.  gambling.

         - are ADDICTIONS just a subcategory of compulsions??

o. making lists.

p. my grandmother made lists, then more lists, then lists of her lists.

q. athletic events: lots of rituals, some socially acceptable or even trained:

         - baseball player must dress in certain way.

         - pitcher goes through ritual of pulling hat.

         - batter goes through bat tapping ritual.

         - batter crosses self.

         - tennis player bounces ball exactly 3 times before serving.  If not right, she starts over.

r. check my mailbox at school even though I know mail delivery is later.

s. “I find myself absolutely compelled to count certain things.”

t. “I have to empty the ashtrays in my house or I am incredibly uncomfortable.”

u. “If I see a picture that is crooked, I feel compelled to straighten it.  I feel extremely anxious if I am unable to straighten it.”


2. Obsessions.  Repeated, unwanted thoughts.


a. something “I just can’t get out of my mind.”

b. popular song that just keeps running through my head.

c. tune or jingle from advertisement.

d. scene from a horror movie, just keeps replaying itself in my mind.

e. scene from an accident I witnessed.

f. I’m ugly.

g. My breasts are (too large, too small, … etc.)

h. My penis is too small.

i. after the death of someone: replay it, feel guilty about it.

j. dwell on the possibility of someone else dying.

k. dwell on the possibility of your own death.

l. replay past events: parent’s divorce, mother’s alcoholism.

m. think of an embarrassing moment.  Continually replay the scene in your mind, even though you know everyone else has forgotten it.

n. jealousy.  Images of boyfriend / girlfriend / spouse / partner with another lover.

o. I forgot something, I screwed something up: continually replay my mistake.

p. worry incessantly about a decision I have to make.


3. Delusions.  False beliefs.


a. after being fired: they were out to get me.

b. I am disgustingly fat.  (cf. anorexia nervosa, but this false belief also exists for “normal” people.)

c. my son died because God called him.  (does this fit?)

d. until age 20, I thought I could get pregnant by swimming in the same pool that boys/men swam in.

e. I believed I was the cause of my brother’s mental retardation (which was a family secret, never discussed openly).

f. parent denies child is mentally retarded, despite obvious indications.

g. similar for child in trouble in school; child with physical problems, child who is dying.

h. more generally, can all situations of Freudian “denial” fit here?

i. smoking isn’t really bad for me.

j. I can drink and drive.

k. teenagers generally: the “illusion of invulnerability” (WvS theory).

l. “My mother denies to herself as well as to others that her daughter is living with her boyfriend.”

m. belief in God (some authors)

n. when someone dies: self blame: it’s my fault; if only I had done X; if only I had said Y.

o. family denial or refusal to see alcoholism.  (Or drug abuse, or sexual abuse.)


Notes for discussion:

Are there categories of socially acceptable delusions?

Argument concerning politics: beliefs not based on logic, dependent on society, culture, family you are raised in.

Argument concerning religion: beliefs not based on logic, dependent on society, culture, family you are raised in. 


4. Hallucinations.  False perceptions.  (Can be visual, auditory, other senses.)


a. after staying up all night: I think I see shadow of person moving, actually it turns out to be just a sweater.

b. driving home at 4 AM late from prom (not drunk!), friend sees people in tuxedos.

c. My cat died, but I still think I see him out of the corner of my eye.

d. I felt caterpillars crawling on me.

e. After my dog had fleas, I kept feeling fleas crawling on me.  (Or spiders, or ticks after walking in field.)

f. After the death of her son, a mother hears him talking in the other room.


5. Paranoia.  Feelings of persecution, being followed, being watched.

a. walking down a road at night: I think I am being followed.

b. as a child, after moving to new town, in new classroom feel like everyone is watching.

c. In general, “feeling self-conscious” about something.

d. Zits.  Hickeys.  Face breaks out, think everyone is watching, noticing.

e. Physical feature about self you don’t like:  too tall; too short;  big ears; nose too big; etc. etc. etc.

f. teenage girl gets her first period, feels like everyone can tell.

g. first time after I had sex, I felt like everyone knew.

h. after a haircut, I felt like everyone was looking at me.

i. social anxiety (under-assertiveness) example: college student who felt like everyone was watching her going through cafeteria line.


6. Phobias.  Exaggerated, unrealistic fears of specific objects or events.


Note: lots of overlap with other categories above.


a. socially acceptable or even trained phobias: spiders, bugs, snakes, mice.

b. fear of getting disease.

c. fear of germs.

d. walking at night: fear of the dark, feeling watched, followed.

e. fear of being seen naked.

f. while sleeping: image of someone in closet.  Must sleep facing (toward) (away from) the closet or the door.

g. at night: image of hand reaching up from under the bed.

h. “I had to sleep with a blanket, even in summer, to provide one extra thickness for the knife to go through.”

i. “I absolutely cannot sleep under a cover because I’m afraid I’ll suffocate.”

j. fear of heights.

k. “I am terrified when driving across a particular bridge.  If someone else is driving, I hide my head.”