by Jake Aronoff
I found numerous strengths in this article, including the attention paid to the negative consequences resulting from determinations of normalcy, the current role of consumerism (as people strive to be normal or ideal), and the alternative conceptualization of degenerate. While Mason shows the extreme consequences of the (ab)normal label, such as prison sentences for certain drug uses, the implementation and justification of racial caste systems, and death as a result of a witch hunt, he also highlights more subtle consequences such as the influence a professional diagnosis of being abnormal can have on job attainment and status, being viewed by the state as a capable parent, or the potentially altered state of other mental conditions. These potential consequences certainly justify the critical self-reflection Mason calls for.
Mason also highlights the role of consumerism, in which individuals are exposed to images of what is ideal, and what is ideal becomes equated with what is normal. Thus, individuals are sold products with the promise of getting closer to, but never actually achieving, the ideal. Mason briefly mentions the involvement of pharmaceutical companies in consumerism, a topic further explored by Hunt et al. (2013). They found that diagnosis criteria are lowering for diabetes, hypertension, and high cholesterol, particularly for minority groups considered to be at higher risk. The result is that the parameters of normal shrink, while the parameters of abnormal grow, resulting in increased diagnoses and increased prescribing (to the point where side effects to prescriptions are treated with more prescriptions).
Another major strength is the alternative conceptualization of degenerate Mason provides. This conceptualization comes from biological systems theory, in which multiple structures can perform the same function. According to this conceptualization, there is not a “one-to-one” structure function relationship. Mason highlights how this can help us understand variation rather than try to erase or ignore it. For example, he notes that mental states and disorders are essentialized and viewed as stable or static. However, brain scanning research has shown that individuals determined to be normal can have brain scans that indicate pathology, while individuals determined as having pathology can have brain scans that look like a brain determined to be normal. Thus, different structures of the brain may be performing similar functions, rather than the conventional thought that one structure performs one function.
One important weakness to this article is that it could have been more constructive on how to go about putting into practice the conclusions provided. While this is understandable given the space allotted and the intentions of the article, much is left to the reader to figure this out. Regarding the call for critical self-reflection, directing the reader to Roepstorff & Frith (2012) would have been helpful, as they focus on methodology in that respect. However, the most sizeable hurdle is how to put into practice a value-free operational conceptualization of degeneracy. Viewing mental states as dynamic and embracing rather than masking and ignoring diversity, as Mason mentions, seems like a plausible first step. However, this could problematize diagnoses, as cutoffs (or clear parameters for what is considered “normal”) are likely needed in order to determine when intervention is needed. This article does not offer a “magic bullet” on how to study and treat mental states, though this may (and I would bet it is) intentional.
Hunt, L., Kreiner, M., & Rodriguez-Mejia, F. (2013). Changing Diagnostic and Treatment Criteria for Chronic Illness: A Critical Consideration of Their Impact on Low-Income Hispanic Patients. Human organization, 72(3), 242-253.
Mason, P. H. (2015). What Is Normal? A Historical Survey and Neuroanthropological Perspective. In Handbook of Neuroethics (Eds.) J. Clausen & N. Levy (pp. 343-363). Springer Netherlands.
For further reading on degeneracy in biological systems theory:
Edelman, G. M., & Gally, J. A. (2001). Degeneracy and complexity in biological systems. Proceedings of the National Academy of Sciences, 98(24), 13763-13768.
Friston, K. J., & Price, C. J. (2003). Degeneracy and redundancy in cognitive anatomy. Trends In Cognitive Sciences, 7(4), 151-152.
Noppeney, U., Friston, K. J., & Price, C. J. (2004). Degenerate neuronal systems sustaining cognitive functions. Journal of Anatomy, 205(6), 433-442.