Social Construction of Abnormality

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KNOWLEDGE BUILDING

The Social Construction of Normality*


by Sophie Freud

Abstract
Our rapidly changing culture raises questions about standards of normality that social workers are often asked to help enforce. The
author insists that we need standards to guide our communal life while also reminding the reader that normality is a mere context-
dependent social construct. The article gives examples of drastically changing standards such as the changing expectations of normal sex-
uality or normal child rearing. Therapeutic standards, partially laid down in the Code of Ethics, are, moreover, the guidelines for social work
practice, given the close interface between ethical values and clinical practice. The ambiguity of the meaning of normal and abnormal is
discussed, suggesting that abnormal behavior may be required in the face of social injustices.

IN THIS ERA OF MOMENTOUS CHANGES in all areas by a friend worrying that his twenty-year-old daughter
of living, the concept of normality is forever being newly had still not had any sexual relations. He did not use the
constructed and reconstructed. It behooves us to partici- word virgin, showing that female sexual relations have
pate in this important process given that the activities of become transformed from a loss — in this case loss of
our social work profession have always been focused virginity — to a gain — in this case gain of sexual expe-
around moral and ethical values. It has thus become one rience. My mind flashed back to my college days at Har-
of our most urgent tasks to examine together the concept vard in ‘44, when a classmate was expelled because she
of normality on which many of our professional activities was seen entering a hotel room with her fiancé, a soldier
are implicitly based, and which is the guidelines for our who was home on furlough and who would be returning
work. The concept of normality is also of interest because to the front after the weekend. It struck me how, within
it involves the ambiguity of linguistic meanings. the span of my own very short lifetime, our sexual mores
had undergone such drastic changes — and they contin-
A Postmodern Stance ue to do so, with changing medical, political, and social
I have called this article “The Social Construction of circumstances, although not necessarily in a linear fash-
Normality” to emphasize the postmodern stance that in- ion. But sexuality is just one of many areas of runaway
forms my thinking — namely that our social and to some change. When a critical mass of people change their be-
extent our physical reality is humanly constructed. Such havior, the deviant may become the norm. I was deviant
a stance implies that there are many possible realities when I worked as a young mother in the 1950s — now
based on many possible truths (Rosen & Kuehlwein, the stay-at-home mother is being frowned upon, and in-
1996). I hope to elaborate that normality is a value-based digent young mothers are being coerced to go to work.
concept; that it heavily depends on the sociopolitical eco- I can think of four not mutually exclusive and per-
nomic context including the historical moment; that it is haps somewhat arbitrary areas that point to the interface
culture specific; and that there is no normality outside a between standards of normality and the moral and ethi-
particular context. cal aspects of our social work activities referring more
specifically to clinical social work practice.
Changing Standards First, we decide as a society who is normal and what
The idea for the subject of this article was triggered should be done with people who deviate from society’s

* This article was first given as a talk, in modified form at the July 3, 1996 World Congress of Psychotherapy Conference in Vienna, Aus-
tria. It was then published, again in a modified form, in German as “Die Soziale Konstruktion der Normalitat” in Psychologie in Osterre-
ich, September 1996. It was then given as a talk for the Chicago Society of Clinical Social Workers on May 2, 1997, and again for Salem
State College School of Social Work on November 24, 1997.

Families in Society: The Journal of Contemporary Human Services


Copyright 1999 Families International, Inc.

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FAMILIES IN SOCIETY • Volume 80, Number 4

expectations — counseling being only one of the more with a particular label, which, once again, has important
benign choices. Who deserves counseling, who is in need consequences in terms of who gets what services and who
of it, or should be coerced into receiving it. will pay for them. Diagnostic labels have quadrupled
within the last twenty years, and the value dimension of
such labels is highlighted by the political debates that
When a critical mass have surrounded some diagnostic labels, such as homo-
sexuality and, more recently, borderline personality (Her-
of people change man, l992), self-defeating personality, and others. Inci-
dentally, I do not agree with those of my colleagues who
their behavior, the deviant disapprove of every kind of label, because I think some
labels have definite useful functions even apart from the
may become the norm. supposition that different treatments fit different diag-
noses. Some labels pathologize widespread human fail-
ings, yet paradoxically, they also normalize them. I have
Second, we may ask, is it normal that counseling and several acquaintances who have suddenly “discovered”
psychotherapy have become a major social institution, after the media blitz about attention deficit disorder
the one which attends to people in pain, the one that re- (ADD) that they might have been suffering from ADD
places religion for solace and replaces family or friends as perhaps all their lives, and the same is certainly true of
major confidants? There may also have been a historical post-traumatic stress disorder. These new diagnoses have
time when people in emotional pain simply kept it to clarified, or at least given meaning to, their personal ex-
themselves. Such long ago people might have been great- periences and almost relieved them from feeling different
ly surprised at the thought that one would want to share and strange. The fuzzy label of ADD, whether accurate-
one’s pain with a professional paid for this purpose. ly applied or not, has lessened their isolation and allowed
Third, psychotherapy’s and social work’s theory and them to join a whole community of people who have a
practice techniques and research methodology all have similar condition. It is possible that diagnostic labels are
value connotations. For example, it is now perfectly ob- not only stigmatizing, but also externalize certain prob-
vious that psychoanalytic theory was originally, almost lems of living, a favorite method of some postmodern
absurdly, biased by a male perspective that saw women therapists (White, 1990).
as “other.” It became normal to view women as castrat-
ed males. Yet we had to await feminist consciousness Anything Goes?
raising before the full impact of this perspective struck Some people are critical toward postmodernism be-
us. With this change of perspective came the realization, cause they think many truths and many possible realities
so well elaborated by Philip Cushman (1995), that all means “anything goes.” I believe the very opposite is
theoretical constructions that define our reality have so- true. Once we lose an absolute and factual universe, we
ciopolitical implications. Not only theory, but practice are only left with the values that we stand for. We cannot
methodology as well, is value-sensitive. Is it, for example, manage a world without some consensual truths, even if
acceptable and therefore normal, to trick patients, such we challenge absolute truths, and in order to live a com-
as through the use of paradoxical techniques or by sub- munal life we cannot manage a world without standards
tle methods of persuasion — for their own good? of normality that we as social workers might well be in a
With our increasing self-consciousness regarding position to enforce, wittingly or unwittingly.
the expression of values in all our activities, we have Although the four points I have made above are
also changed our approach to research, sometimes even quite encompassing, we could generalize them to an even
in fundamental ways. Many attempts are currently greater extent. Philosophers have reminded us that all the
made to transform the objects of our research into activities of our life are embedded with assumptions
collaborative participants. about the right kind of life that a person should lead. Val-
Fourth — and I am still enumerating the interfaces ues, it is said, are not superimposed on a constructed re-
between normality, values, and social work practice — ality, but the very construction of social reality (and by
values very much enter into what we call assessment. extension normality) is based on and intertwined with, in
Often we are expected to diagnose each kind of trouble John Christopher’s words, (1996) “moral visions.”

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Freud • The Social Construction of Normality

Cultural Values tively nonviolent domestic relations, and all rather mod-
There are mental health professionals who claim ern ideas.
that they accept and respect all cultural differences. But These two usages create a great deal of confusion, es-
this is easier said than done, and one need not be a stu- pecially if normality refers to a presumed statistical aver-
dent to be puzzled and confused when confronted with age. For example, consider the widespread incidence of al-
cultural values that contradict our social work values. I coholism and/or depression around the world. Or
believe that some cultures and some subcultures in our consider the prevalence of child sexual molestation in this
own society are more benign than others, and that we country as well as other countries. Normal, in terms of
should be ethically allowed to guide our clients toward average, thus becomes abnormal, in terms of ideal. One
more, rather than less, humane cultural possibilities. It is might think that such a stark discrepancy between some
also true that some of our clients’ values are not cultur- mental health ideal and actual conditions is a startling sit-
ally based but have arisen as a response to oppression, uation. Either our social structures are not conducive to
and this is an important distinction. Maybe I should have mental health, or the ideals of mental health are indeed so
made this fifth and most important point: values deter- utopian that they have become useless and need revision.
mine our clients’ goals when they seek help, as well as
our own goals as counselors. Sometimes the counseling
situation is viewed as a hermeneutic dialogue between Certainly, in the area
these two sets of goals.
of sexuality, people’s actual
Definition
Forgive me for being already way beyond my intro- behaviors seldom match
duction without having attended to defining the concept
of normality, concentrating on its common usage rather official norms.
than on purely dictionary definitions, and here I lean
upon and expand some of the pioneering work by Offer
and Sabshin (1984). The third meaning of normality refers to convention-
One meaning of normality refers to a statistical av- al behavior based on current community standards of a
erage, or more accurately, a statistical mode. Not a true, presumed majority of people. It refers to the behavior or
one, but a widespread condition as imagined by people. rather presumed behavior of one’s friends and neighbors.
When people say “I had a normal childhood” or “I have It means not being weird, eccentric, or insisting on one’s
a normal sex life,” they usually refer to an imagined so- own way of doing things. When people use the word ab-
cial norm. In this sense, normality is meant positively normal, they usually refer to this sense of normal, and it
with the connotation of nondeviant and socially accept- is here that normality is equated with being good and ac-
able events but does not suggest any excellence. Some- ceptable while abnormality is reprehensible, deviant, per-
times such a use of normality can also refer to mediocrity. haps even illegal. Most people view it normal, for exam-
A teacher once told me that my child had “normal intel- ple, to grow up heterosexual and abnormal and therefore
ligence,” which upset me greatly until I learned that she objectionable, to develop any other way. You can appre-
compared her with her classmates, a group of gifted chil- ciate how this third use of normal can include participa-
dren. This example highlights that most people who use tion in every form of atrocity human beings have been
“normal” in the sense of “average,” have a reference able to invent. I now have given three possible definitions
group in mind and that this reference group may not be of normality upon which I want to expand.
considered normal by other people.
A second meaning of normality refers to normality Normal Sex
as a highly positive value, not just absence of physical or Psychotherapy and the psychological theories on
mental disorder. We might call this “normality as a men- which the institution is based have been given the so-
tal health ideal.” Perhaps it is this meaning of normality ciopolitical function of judging and maintaining stan-
as desirable behavior that is closest to our own common dards of acceptable normal behavior. This is seldom done
use. It is a meaning that is, of course, driven by our val- arbitrarily since psychological theories leaning on my
ues about the good life, such as the desirability of the third definition of normality are apt to be a mirror of the
longest possible life and the right to happiness, and rela- conventions of their time. For example, we have been

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FAMILIES IN SOCIETY • Volume 80, Number 4

taught that psychoanalytic theory was a radical depar- ple of one area of cultural practice of which I want to in-
ture from the usual conventions, but Michel Foucault sist that, while there is a range of acceptable cultural child
(1976) has suggested that Freud’s sexual theories, far rearing differences, there are better or worse ways of rais-
from shocking the burghers of Vienna, were instead, a re- ing children.
flection of the nineteenth century intense preoccupation Once a theory of normality is established—let us say
with sex, perhaps similar to the twentieth century im- a widespread theory such as Erikson’s (1950) stages of
mersion in violence. development, later enlarged into the expected phases of
We may have been pressured to come to terms with the adult life cycle (Levinson, 1978) complete with its
homosexuality, but many of us might still insist that there midlife crisis—description becomes prescription, which is
are natural and perverse ways of being sexual. A cross- then transformed into a desirable standard of normal be-
dresser or fetishist is said to be perverse. Perversity is a havior to be upheld and maintained by the educational
category that society has constructed to forbid or at least system, the religious system, the legal system, and of
discourage certain sexual practices. We might be “in- course the psychotherapeutic system, and to which every
stinctively” repelled by perverse practices because we section of the population has to measure up to or be
were socialized that way. Yet, we know that different sex- found deficient. The midlife crisis is, by the way, a good
ual practices have been viewed as perverse in different example of having been en vogue for some years, to the
historical periods. Masturbation was held responsible for extent that everyone from thirty to sixty suffered from
a wide range of mental illnesses in the eighteenth and such a crisis, and then it died a merciful death.
nineteenth century. I am uncertain just when oral sexual-
ity has been taken off the list of perversities. Some per-
versities, like voyeurism, may be illegal in one context In times of moral crisis,
and recreational in another context such as in the form
of adult videos. it is abnormal behavior
Certainly, in the area of sexuality, people’s actual be-
haviors seldom match official norms. Each time a new bi- that comes closest to the ideal
ography of some famous person is published we find,
perhaps with increasingly less surprise, that their public of humanistic values.
image did not conform to their actual private sexual be-
havior. Mary Catherine Bateson (1984) was blamed
when she revealed that her mother, Margaret Mead, had, Mental Health Professionals and the Family
besides her four husbands, a longtime woman lover. I Mental health professionals have added to the con-
think her decision to reveal her mother’s secret was a fusion between normal as average and normal as desir-
courageous move, helping to normalize millions of bisex- able, by writing as if their theoretical utopian ideals were
ual persons. Currently our politicians — when subjected common and widespread norms. This is especially true
to scrutiny about their sexual conduct — are also found when we teach and write about families. For many years,
wanting, creating the dilemma of upholding a social psychological textbooks, children’s first schoolbooks,
order — a standard of sexual normality — that does not and of course the popular media, described family life in
exist in actual practice. such glowing terms that each family fell short of the pub-
I could write at great length about the changing stan- lic ideal of family as “a haven in a heartless world,”
dards of normal child rearing. Space constraints allows (Lasch, 1977) and its members lived in private shame
only one arbitrary example. People of my generation were about their own particular defective family. I even think
raised by a rigid four-hour feeding schedule. I have heard the excessive expectations of what a good marriage
stories of mothers who had to be locked into their rooms ought to look like contributed to the rising disappoint-
while listening to their babies’ daily screams of hunger, ment and sense of betrayal when the idealistic standards
hour after hour, month after month. Presumably this and the stark reality simply did not match. It is amusing
practice readied the infant for an orderly and punctual to hear some of the public outcries about Arlie
adult life. Mothers who currently do not feed their chil- Hochschild’s (1997) Time Bind, in which she declares the
dren when they are hungry might be viewed as abusive — very opposite, namely that work is a haven against a
a vivid example of how norms of one period become problematic family, a new wisdom that many women and
transgressions in the next generation. It is also an exam- men had known long ago.

336
Freud • The Social Construction of Normality

The passing of the classical textbook family of dad, ilies with strong guilt and loyalty ties, were disinclined to
mom, son, daughter, and dog is forever being lamented be critical of their parents and tended to view their back-
by politicians, but its decline can apparently not be grounds as normal. One could debate which self-
stopped. Not only can mom be a single parent, but dad definition is more conducive to mental health. Psychody-
may be an unknown donor of semen used for artificial in- namic theory suggests that a realistic evaluation of paren-
semination. There may be two lesbian moms or two gay tal failings and acknowledgment of childhood traumas
dads. A child may be born to a thirteen-year-old mother are important aspects of self-development and eventual
and not be welcomed by anyone, or else children may healing. We think that people who ignore their own suf-
have a whole series of stepparents. This latter case may fering, past or present, eventually pay a high price. In spite
give them a sense of being surrounded by loving adults, of the advantages of this approach, there is also a danger
or alternately, shuttled back and forth between quarrel- that excessive embracing of a victim identity may lead to
ing adults who all lay claim on them. These two last al- becoming embedded in this status, rather than leaving it
ternatives are a good example of how the same circum- behind. Interest in explanations for one’s behavior and
stances may have different consequences depending on suffering replaces a readiness for change. We should not
the problem-solving skills a divorcing family can develop look for an either/or answer, yet I consider this question
and, indeed, which we may help them develop. The new one of the important unsolved issues of trauma theory.
diversity of possible family forms has had the consider-
able benefit of helping to destigmatize any one of them, Reframing Lives
which is generally true when diversity is introduced into Actually, as we continually reconstruct our own his-
a situation. Yet, I maintain, as I mentioned earlier, that tory, we might switch back-and-forth in our own evalua-
even in these revolutionary times, we as social workers tions of whether we had a normal childhood, given the
responsible for the welfare of children, are called upon to confusion of standards of normality. I used to think I had
apply some standards of normality regarding how chil- had a difficult childhood, an abnormal one. Then I became
dren are reared in families. Some social workers, like a social worker and learned what a bad childhood could
Froma Walsh (1993), have done important pioneering be like: being abused, neglected, persecuted, starved, etc.,
work in this area, substituting for the old structural def- and suddenly I changed my reference group and decided I
initions, new and creative definitions of desirable family had had a privileged, well-protected childhood.
processes. We have thus happily traveled from the bro- An effective technique of brief psychotherapy is to
ken families and illegitimate children of my social work normalize a particular behavior or situation. Sometimes
beginnings, to families that either do or do not provide the best we can do for people is to help them accept
the emotional climate conducive to the development of themselves with their particular strengths and vulnerabil-
its members. Walsh points to new standards of family co- ities. I had a client who worried about having frequent
hesion, flexibility, open communication, and problem- anxiety attacks in response to relationship problems. I
solving skills as offering new criteria of optimal normal- highlighted his accomplishments as a competent busi-
ity, while also taking unique circumstances into account. nessman (he made and sold ice-cream) and encouraged
I used to assign my competent and mostly well- him to accept himself as he was, with his high emotion-
functioning social work graduate students short bio- ality and “super-caring style” as having advantages
graphical essays and was appalled when year after year, I (being a good and feeling person) as well as costs (suffer-
read about the massive pathology in their families, in- ing pain and anxiety).
cluding alcoholism, of course, mental illness, intrafamil- Seeking out the pathological core of every phe-
ial violence, etc. Other teachers have had similar experi- nomenon is a use of psychoanalytic theory in which all
ences. The average, normal family is not anything like the human motives are, by definition, suspect. In recent
“good enough” family we mental health professionals years, some mental health professionals have turned mat-
might hope for and use as a standard against which we ters around, seeking for seeds of strength in discouraging
measure our clients. situations. Reframing is an admirable technique, but like
The students themselves were divided in their own all else, it has its shadows. Economics seem to have a cru-
evaluation of their families. The more middle class and cial role in defining who is in need of mental health ser-
more psychologically sophisticated students tended to vices. Insurance companies who pay for these services
blame their parents. Others, mostly those from working want us to declare everyone as normal, while mental
class or racial minority backgrounds, bound to their fam- health professionals who need patients are more inclined

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FAMILIES IN SOCIETY • Volume 80, Number 4

to define people as needing psychotherapy, and both may of evil” was severely criticized, but I merely see it as a
be right. The whole point of this article is to alert us to clash between the concept of normality as an utopian
the uncertain shifting boundary between the social con- ideal and my third definition of normality as joining your
structions of normality and abnormality. neighbors in a lynching party, indulging in mindless
vengefulness, and appalling cruelties, that most of us do
Normal Emotions not recognize in our own emotional repertory. Yet we
Our cultural norms even dictate the appropriate have seen with horror and astonishment how easily sav-
emotions that are to be felt at various occasions (Nunley agery can be unleashed, not only in Germany (although
& Averill, 1996). Indeed, the absence of certain emotions Germans were exceptionally proficient and methodical),
or the expression of wrong emotions are bound to create but in every nation, in every continent, in every racial
social havoc. Many of us would view the teaching of group. There were some Germans who did not participate
proper and differentiated emotions expected by our cul- in the Holocaust, but they were the abnormal ones, the
ture as an appropriate therapeutic task. Consider some- ones that did not follow the accepted and even coercively
one who does not feel gratitude when “appropriate.” We expected community norms of torturing and killing whole
have even learned that when expected emotions are not groups of other people defined as inferior or subhuman.
forthcoming, for example, grief at a parent’s death, we In times of moral crisis, it is abnormal behavior that
declare them to have been repressed. comes closer to the ideal of humanistic values.

Combat as a Normal Life Experience Conflicting Values


There is another issue of normality I wish to raise, The reason why the concept of normality has
namely the grim consequences of certain normal life ex- become so fuzzy to the point of making the very word
periences. In World War I, soldiers who collapsed in bat- normal a problematic word, is that as a society, we can
tle were called “shell shocked,” and everything was done no longer agree on our values. There is a current debate
by the military psychiatrists, including giving them to abolish “no-fault divorce” in some of our states be-
frightful electric shocks, to get them over this “abnormal cause the policy is suspected of encouraging divorce. Do
condition” and back into battle. In World War II the phe- we want a young couple in constant conflict and mutual
nomenon continued under different diagnoses. Now we lack of respect to stay together for the sake of the chil-
have studies that find that an alarming number of men dren? Is it desirable for an old couple whose relationship
who have experienced active combat subsequently live has died long ago to stay together and take care of each
with life-long symptoms of post-traumatic stress disor- other? Should we honor and stay in helpful touch with
ders (PTDS), to a greater or lesser degree (Journal of our old parents who may have been uncaring, negligent,
Traumatic Stress, 1997). or perhaps cruel when we were children? Is patriotism a
Nobody would call PTDS a normal condition, yet it virtue? Is readiness to die for one’s country or live an
appears to be the natural consequence, not only of agreed emotionally crippled life forever after a war a sign of
upon, albeit not very unusual, destructive life experiences manly courage and nobility? Is abortion a tragic loss of a
like torture, natural disaster, concentration camps, or child potential Beethoven or an act of responsibility? Should
abuse, but of the normal patriotic duties that young men self-seeking, called self-actualization, or altruism be more
are expected to perform for their country. Human beings praised? I would assume that many readers of this article
are a very adaptive species, but there are biological limits might have very different opinions on these issues. Yet,
to human adaptation, which brings me back to values. these are questions that we meet in our daily social work
practice, and our personal views will influence our reac-
Anything Goes Revisited — Humanistic Values tions. It might even be best to admit our own biases to
In a recent controversial book, the author Daniel our clients and engage in honest debates with them re-
Goldhagen (1996) accuses the German people of having calling the hermeneutic dialogue I referred to earlier.
been abnormal during the Nazi period. He meant that
they did not embrace the supposedly pervasive humanis- Normality and the Code of Ethics
tic values of Western civilization. It was a different thesis I think the very realization of many possible truths
from that of Hannah Arendt (1963), who viewed Eich- and our uncertain empirical research, along with the idea
mann for example, as a “normal” bureaucrat who was that all theories have political shadows — rather than
simply following orders. Arendt’s thesis of “the banality leading us to the conclusion that “anything goes” — have

338
Freud • The Social Construction of Normality

to the contrary turned us toward greater reliance on struction of even more prisons and the new institution of
some common ethical standards. I am referring to our chain gangs as the only response to structural escalating
Code of Ethics, which we knowingly have constructed violence. Do we live in a just society when some members
through a consensual process led by our professional col- of the society earn up to one hundred times as much as
leagues. Our Code of Ethics has become a bastion that other at least equally-hard-working citizens? Are we
protects our practice and guides our actions, perhaps re- going to be owned by insurance companies? Are we giv-
cently even more so than the theoretical frameworks on ing up on fighting for our clients? The time may have
which we used to rely. We have come to understand that come, in alliance with other mental health professionals,
ethical, legal, and clinical issues are inextricably interwo- to construct a manifesto that defines the boundaries
ven. We can view codes of ethics in general as profes- within which we can fill our societal functions as
sional constructions of normality that guide us in an age guardians of normality, constructors of good citizens,
of ambiguity. Yet, the social work code of ethics, in all its and protectors of children. Maybe the moment has come
pristine newness, does not solve all our problems. It rais- for us to behave abnormally in its third definition.
es issues of enforced practice conformity; it does not ad-
dress the important issue of who will receive and pay for
our services; more importantly, it does not address the References
larger issue of social justice without which our services
may often be futile.
Arendt, H. (1963). Eichmann in Jerusalem. New York: Viking.
Bateson, M. C. (1984). With a daughter’s eye. New York: William
The Personal Is the Political
Morrow.
The stark discrepancy between normality as average Christopher, J. C. (1996). Counseling’s inescapable moral visions. Jour-
and normality as an ideal could lead us to seek the roots nal of Counseling and Development, 75, 1-25.
of dysfunctional behavior in our cultural arrangements, Cushman, P. (1995). Constructing the self, constructing America. Read-
rather than in individual histories, but we are generally ing, MA: Addison-Wesley.
Erikson, E. H. (1950) Childhood and society. New York: W. W. Nor-
reluctant to do so. Psychotherapy and most human ser-
ton.
vices at their best, incorporate many humanistic values. Foucault, M. (1976). The history of sexuality. (Vol. I). New York: Pan-
Ideally, they stand for attentiveness and respect for each theon.
individual, no matter how humble or deficient in the eyes Goldhagen, D. (1996). Hitler’s willing executioners: Ordinary Germans
of society. It values confidentiality, non-exploitation, and the Holocaust. New York: Knopf.
Herman, J. L. (1992). Trauma and recovery. New York: Basic Books.
honesty, self-knowledge, responsibility, and compassion.
Hochschild, A. (1997). Time bind. New York: Metropolitan Books.
But in a capitalist society, the human services are in dan- Journal of Traumatic Stress, 10(3), 1997.
ger of becoming yet another commercial enterprise, Lasch, C. (1977) Haven in a heartless world. The American family be-
which is by definition, embedded in the profit motive sieged. New York: Basic Books.
with people as commodities. Unless we recognize the Levinson, D. J. (1978). The seasons of a man’s life. New York: Knopf.
Nunley, E. P., & Averill, J. (1996). Emotional creativity. In H. Rosen &
moral aspects of our work, put ethical principles as its
K.T. Kuehlwein (Eds.), Constructing realities. San Francisco:
very highest purpose, and insist on the interaction be- Jossey-Bass.
tween societal arrangements and mental health, it will Offer, D., & Sabshin, M. (1984). Normality and the life cycle. New
become just one more consumer enterprise competing York: Basic Books.
with cosmetic surgery and Disneyland as the royal road Walsh, F. (1993). Normal family processes. Second Edition. New York:
Guilford Press.
to happiness. We are at a turning point in our professions
White, M., & Epston, D. (1990). Narrative means to therapeutic ends.
and have to make some choices. I view the current crisis New York: Norton.
in the field as the conflict between social work values and
the values of the larger society as expressed by our elect-
ed delegates. Sophie Freud is professor emerita, Simmons College School of Social
Work, Boston, MA.
Many of us have started to feel hopeless and helpless
about current trends of so-called managed care, of con- Original manuscript received: July 7, 1998
stantly diminishing resources for our clients, of the con- Accepted: August 1, 1998

339

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