What's So Great About Normal, Anyway?
A psychiatrist explains how your most worrisome idiosyncrasy might be your greatest gift.
Photo: Mauricio Alejo
When Dale Archer, MD, began practicing medicine in 1987, most of his patients viewed psychiatric drugs as a last resort. Today, he says, the pendulum has swung in the opposite direction. "People now come to me thinking they need treatment if they're simply not as focused or outgoing as the folks around them." In his new book, Better Than Normal, Archer argues that the definition of psychiatric health has become so narrow that almost anyone can be labeled with a disorder—but that some disorders have traits that, in fact, should be embraced. We asked him to tell us more.
Q. What's wrong with the way psychiatric conditions are classified?
A Harvard Medical School study concluded that approximately one in four American adults has a mental disorder—now, that's crazy! In the book, I describe eight characteristics that, when dominant, have become the bases for diagnoses. Shyness, for example, is a symptom of social anxiety disorder, self-focus falls under the umbrella of narcissistic personality disorder, and adventurousness can be taken as a symptom of attention deficit hyperactivity disorder. But in reality, we all have a little bit of those traits within us. They exist on a continuum. You might be further along on one continuum, but unless you're at the extreme end of it, you probably don't need drugs.
Q. Why not treat the mild cases?
When you're always trying to conform to the norm, you lose your uniqueness, which can be the foundation for your greatness. Take people on the bipolar continuum. They tend to be very competent and creative, and they have the energy to follow through with ideas. They're resilient and likable—their enthusiasm and joie de vivre is contagious.
Next: When it's okay to procrastinate
Q. What's wrong with the way psychiatric conditions are classified?
A Harvard Medical School study concluded that approximately one in four American adults has a mental disorder—now, that's crazy! In the book, I describe eight characteristics that, when dominant, have become the bases for diagnoses. Shyness, for example, is a symptom of social anxiety disorder, self-focus falls under the umbrella of narcissistic personality disorder, and adventurousness can be taken as a symptom of attention deficit hyperactivity disorder. But in reality, we all have a little bit of those traits within us. They exist on a continuum. You might be further along on one continuum, but unless you're at the extreme end of it, you probably don't need drugs.
Q. Why not treat the mild cases?
When you're always trying to conform to the norm, you lose your uniqueness, which can be the foundation for your greatness. Take people on the bipolar continuum. They tend to be very competent and creative, and they have the energy to follow through with ideas. They're resilient and likable—their enthusiasm and joie de vivre is contagious.
Next: When it's okay to procrastinate
Q. So where do you draw the line between a trait that makes you who you are and one that needs treatment?
The rule of thumb is, when your condition prevents you from doing the things you want or need to do, then it needs treatment. If you're an obsessive-compulsive type, which I call perfectionist, and you're spending three hours every day washing your hands, then yes, you need to have that addressed. But I saw a woman not too long ago who was a ten-plus on the OCD continuum, and she was doing fantastic. She recognized that she had this trait and found a job as an event planner, where attention to detail was paramount.
Q. I scored extremely high on your ADHD scale. Are you telling me it's okay to procrastinate?
If you're on the high end of the ADHD continuum, I imagine you get bored very quickly, so you move from task to task. You thrive on excitement. You need stimulus, and to deal with that, you wait until your deadline is imminent, when fear of missing it stimulates your brain to focus. You'd likely have a hard time working ahead. And I honestly don't think the quality of your work would be as good.
A Few Surprising Facts About You
The rule of thumb is, when your condition prevents you from doing the things you want or need to do, then it needs treatment. If you're an obsessive-compulsive type, which I call perfectionist, and you're spending three hours every day washing your hands, then yes, you need to have that addressed. But I saw a woman not too long ago who was a ten-plus on the OCD continuum, and she was doing fantastic. She recognized that she had this trait and found a job as an event planner, where attention to detail was paramount.
Q. I scored extremely high on your ADHD scale. Are you telling me it's okay to procrastinate?
If you're on the high end of the ADHD continuum, I imagine you get bored very quickly, so you move from task to task. You thrive on excitement. You need stimulus, and to deal with that, you wait until your deadline is imminent, when fear of missing it stimulates your brain to focus. You'd likely have a hard time working ahead. And I honestly don't think the quality of your work would be as good.
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