D571 Task 1 Abnormal Behavior Cultural Analysis Example

She Still Hears Him Say Good Morning: Historical and Cultural Perspectives on Abnormal Behavior Applied to a Composite Widow's Experiences After Her Husband's Death

Student Name

Leavitt School of Health, Western Governors University

D571: Psychopathology, Task 1

Course Instructor

Month Day, Year

She Still Hears Him Say Good Morning: Historical and Cultural Perspectives on Abnormal Behavior Applied to a Composite Widow's Experiences After Her Husband's Death

Introduction

Whether a behavior is called abnormal depends on who is judging, when and where. The same experience may be treated as a spiritual gift in one community, a normal part of grief in another and a symptom of psychosis in a third. This paper applies historical and cultural perspectives to a composite case: a 67-year-old widow who hears and sometimes sees her late husband. It explains how explanations of abnormal behavior have changed over time, applies a common framework for defining abnormality, and shows how culture shapes whether her experience should be viewed as a disorder under current definitions.

The Case

Graciela Ramos, 67, lives in San Antonio, Texas, in the house where she and her husband, Ernesto, raised four children. Ernesto died of a stroke nine months ago after 44 years of marriage. Since then, Graciela has heard his voice say buenos días, mi amor on many mornings, and twice she has seen him sitting in his chair on the back porch for a moment before the image faded. She finds the experiences comforting. She talks to him at a home altar with his photograph, candles and his favorite coffee, especially around Día de los Muertos. She sleeps less than before and cries often, but she cooks for her grandchildren every Sunday, attends Mass, and has taken over the family's finances.

Her youngest son, who lives in Chicago, became alarmed when she mentioned the porch and asked her doctor whether she might be developing dementia or a psychotic disorder. Her daughters, who live nearby, see nothing unusual; their grandmother described similar experiences after their grandfather died.

Historical Perspectives on Abnormal Behavior

Across history, three broad explanations of abnormal behavior have competed. Supernatural explanations, common in many ancient and medieval societies, attributed unusual experiences to spirits, gods or demons, and treatment took the form of prayer, ritual or exorcism. Somatogenic explanations, going back to Hippocrates, located the cause in the body, originally in imbalances of bodily fluids and later in the brain. Psychogenic explanations, which gained influence in the nineteenth and twentieth centuries, located the cause in psychological processes such as unresolved conflict or learned patterns.

Each lens would read Graciela differently. A supernatural lens might see real contact with a spirit, which fits her own family's understanding. A somatogenic lens asks whether a stroke, dementia or medication could be producing the perceptions, which is the question her son raised. A psychogenic lens sees the mind working through loss. Modern practice combines the last two within a biopsychosocial approach and, increasingly, takes the first seriously as part of the person's cultural meaning system.

Definitions of disorder have also changed within living memory. Homosexuality was listed as a mental disorder in the American Psychiatric Association's diagnostic manual until 1973, a change driven by research and advocacy rather than by any change in people themselves (Drescher, 2015). Grief has moved as well: the current manual removed an exclusion that once kept recently bereaved people from being diagnosed with major depression and added prolonged grief disorder as a new diagnosis (American Psychiatric Association [APA], 2022). Definitions of abnormality are human judgments that shift over time.

Applying the Four Ds

A common framework judges behavior abnormal when it shows deviance, distress, dysfunction and danger. Deviance: hearing a voice no one else hears is statistically unusual in the general population, but it is not unusual among widowed people. A critical review of population and clinical studies found that post-bereavement hallucinatory experiences are reported by roughly 30% to 60% of widowed people, most of whom have no history of mental disorder (Castelnovo et al., 2015). Measured against her cultural and situational peers, Graciela's experience is not deviant. Distress: she describes the experiences as comforting, not frightening. Dysfunction: she continues to care for her family, manage money and attend church. Danger: there is no risk to herself or others. On all four criteria, her experience does not meet a reasonable threshold for abnormality.

Cultural Perspectives and Current Definitions

The current diagnostic manual defines a mental disorder partly by excluding responses that are expected or culturally approved, such as common responses to the death of a loved one, and it asks clinicians to consider a person's cultural background before interpreting unusual experiences (APA, 2022). Its cultural formulation guidance encourages clinicians to ask how the person and her community understand what is happening.

In many Mexican and Mexican American families, relationships with the dead continue openly. Home altars, conversations with the deceased and the yearly observance of Día de los Muertos express the belief that the dead remain part of the family. Within that frame, hearing Ernesto's greeting is meaningful and acceptable. Graciela's son, who has lived for twenty years in a different cultural environment, interprets the same report through a medical frame. Neither view is simply wrong, but only one matches the meaning Graciela herself gives the experience.

When Would the Experience Warrant Concern?

A culturally informed view does not mean ignoring risk. A clinician should rule out medical causes, particularly because stroke and dementia are common at her age, and should ask about memory, confusion, and perceptions unrelated to her husband. Concern would be justified if the voices became commands, frightening or constant; if she stopped eating, caring for herself or seeing family; if she expressed a wish to join him in death; or if intense longing still dominated her days well after the first year, which could suggest prolonged grief disorder (APA, 2022). Her doctor's reasonable course is a brief cognitive screen, a conversation about what the experiences mean to her and follow-up in a few months.

Conclusion

Graciela's experiences would have been read as spirit contact in one era, a bodily imbalance in another and a symptom in a third. Current definitions, applied with cultural knowledge and the four Ds, point to a common and often comforting part of grief rather than a disorder. Her case shows why abnormality cannot be judged apart from history, culture and the meaning a person gives her own experience.

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787

Castelnovo, A., Cavallotti, S., Gambini, O., & D'Agostino, A. (2015). Post-bereavement hallucinatory experiences: A critical overview of population and clinical studies. Journal of Affective Disorders, 186, 266-274. https://doi.org/10.1016/j.jad.2015.07.032

Drescher, J. (2015). Out of DSM: Depathologizing homosexuality. Behavioral Sciences, 5(4), 565-575. https://doi.org/10.3390/bs5040565