Who decided what
counts as normal?
Which standards are judging this life?
How narrative therapy, drawing on ideas about power and normalising judgement, helps people notice the standards their lives are measured against, and who set them.
What this is: a page on dominant stories, power and normality.
Why it matters: descriptions like “independent”, “productive” or “difficult” shape treatment, opportunities and self-understanding.
The sharpest reframe: a standard isn’t a fact about you. It has a history.
One thing to take away: ask whose description is being treated as authoritative.
The short version
Narrative therapy draws on the philosopher Michel Foucault’s idea that modern societies govern people partly through “normalising judgements”: standards of what a normal, healthy or productive person should be, which people then apply to themselves. Disabled lives are measured against many such standards. Narrative work makes these visible as standards with a history and a source, so that people can decide whether they still want to be judged by them. This is a philosophical lens, not proof that every difficulty is socially made.
You might recognise this
Illustrative statementsDrawn together from common experiences. They are not quotes from individual people.
Three questions
Established ideas- Who decided what counts as normal here?
- Whose description is treated as authoritative?
- What becomes hard to notice once that description takes over?
Pairs that judge
Our frameworkIndependent / dependent
Productive / unproductive
Compliant / difficult
Inspiring / negative
Capable / incapable
Normal / abnormal
Each pair carries a judgement. Each can show up in a medical record, a benefits assessment, a school report or a family’s worry, and then in how someone talks about themselves.
Méabh is 35 and has fibromyalgia. Her occupational health report calls her “resistant to graded return”. In therapy she starts by saying she must be lazy. Asked who first described her that way, she pauses: “Actually, it was the report. Before that I thought I was exhausted.”
Méabh is a fictional teaching example, not a real person.
Where power comes in
Some descriptions carry more weight because of who makes them: a consultant, an assessor, a school, a court. Narrative questions can ask:
- Where did this description come from, and when?
- What was it for: treatment, funding, discipline, risk?
- What did it leave out?
- Has it followed you into places it doesn’t belong?
This isn’t about rejecting all professional description. A diagnosis can be useful and wanted. It is about whether one description has come to stand for the whole person.
When a professional description helps
Darach was diagnosed autistic at 34. For him, the diagnosis was the first description that made sense of his life: “For thirty years people called me rude. Now I have a word that isn’t an insult.” Narrative work with him didn’t question the diagnosis. It explored which descriptions he wanted to keep, which he wanted to retire, and who had given him each. Darach is a fictional teaching example.
A professional description can be liberating. The question isn’t whether it came from a professional, but whether it leaves the person enough room.
A caution
Seeing that a standard is socially made doesn’t mean the difficulty behind it is imaginary. Méabh’s pain is real. The question is not whether she is tired, but whether “lazy” is the right word for it, and who gave her that word.
What needs attention here?
An official description has become a self-description
Possible focus: where it came from and what it left out
What to avoid: dismissing the professional context entirely
The person values a standard, such as productivity
Possible focus: what it means to them, and what it costs
What to avoid: telling them to abandon it
The underlying difficulty is real
Possible focus: both the difficulty and the judgement attached to it
What to avoid: treating the difficulty as only a story
Possible starting points, agreed with the person, not rules.
How you’d know it helped
- The person can see a standard as a standard, not a fact.
- They choose which standards they still want to live by.
- An official word has less power over how they see themselves.
Words you can use
For clientsQuestions worth carrying, as a therapist
Therapist Reflection- Which standards am I using to judge progress?
- Do my notes contain judgements, like “resistant”, that a client might adopt?
- Have I respected the parts of a standard the client values?
Evidence & sources
Sources checked in October 2026, using targeted searches rather than a systematic review. “We have not located” means our searches did not find it.
Narrative therapy’s debt to Michel Foucault, including his account of power and normalising judgement: White, M. & Epston, D., Narrative Means to Therapeutic Ends (Norton, 1990).
The idea of ableism as a structural system of beliefs about normality: Campbell, F. K., Contours of Ableism (Palgrave Macmillan, 2009).
The list of judging pairs, the questions about power and the caution are this site’s synthesis.
Méabh is constructed for learning. She is not a real person.
We have not located research on how professional descriptions in disabled people’s records shape their self-descriptions.
How to cite this page: Donaghey, C. (2026). Who Decided What Counts as Normal?. Disability in Psychotherapy. Available at: https://disabilityinpsychotherapy.online/what-is-psychotherapy/narrative-therapy/who-decided-what-counts-as-normal/ (Accessed: [date]).
Shared under CC BY-NC 4.0: you can share, adapt and teach from this page, including on fee-paying courses, with credit. See Reusing This Material.