Book Review: Plea for a Measure of Abnormality

First published in France in 1978, this book is now available in English with a new preface by Joyce McDougall – a supervising and training analyst at the Paris Psychoanalytical Society. This is a valuable and readable addition to the psychoanalytic literature in which McDougall shares with refreshing honesty a number of searching questions about herself as an analyst and the whole analytic enterprise – a rare offering indeed in the field.

The book explores a number of familiar psychoanalytic themes and concepts (e.g. sexual perversions; narcissism; countertransference), and each chapter is illustrated by case studies. Throughout, McDougall questions not only the limitations of patients and analysts but also the limits of the analyst; her commitment to this aim offers the reader a rare opportunity for a deeper appreciation of psychic vitality in all its forms, particularly those 'creations' which by virtue of the form they assume (e.g. psychosis and sexual perversions) are labelled by many as pathological manifestations. However, as the title of the book suggests, McDougall argues with compassion in favour of "a measure of abnormality" highlighting how overadaptation to external reality may lead to what she calls "pathological normality". This is a theme she develops throughout the book illustrating with poignant case examples how some individuals may not create anything sublime or pathological but rather create the protective shield we call 'normality'. This leads McDougall to reflect on a number of important and provocative questions: Does a normal personality structure really exist? What is normality? Is a normal person someone who needs analysis or not?

This is a book I highly recommend as it raises fundamental questions about what is meant by 'normality' and 'psychopathology' – a dichotomy that we all too often perhaps take for granted. Whether one is comfortable with the psychoanalytic language and assumptions that underlie McDougall's "private metapsychology" or not, this book raises questions we should all be asking ourselves irrespective of our theoretical allegiances.

Alessandra Lemma