Alternatives To The Medical Model

The Medical Model Psychology

The medical model is a school of thought in psychology that explains mental illness resulting from a physical cause. The medical model relies on diagnostic criteria to identify if someone has a particular mental illness.

However, behaviourist, cognitive, cognitive neuroscience, psychodynamic, and humanistic psychologists believe that mental illnesses have different roots.

Cognitive neuroscience has many similarities to the medical model; similar to the medical model; it assumes that mental illnesses are caused by brain dysfunction in particular brain regions.

Implications of The Medical Model

The medical model makes several implications regarding mental illnesses -- some may be intentional while others are not. One significant implication of the medical model is that there is something 'wrong' if a person is diagnosed with a mental illness.

However, critics of the medical model argue that this implication puts too much focus on solving a problem and not enough on considering individual needs. It also risks forcing people into a specific label or disorder rather than viewing each person's unique challenges.

Fig 1 - The medical model risks forcing people into a label.

The Medical Model And Thomas Szasz Theory

A Hungarian psychiatrist Thomas Szasz was also opposed to the medical model. Thomas Szasz believed that mental health is a myth. He criticised the medical model because:

• He thought that illnesses considered mental were just ordinary human experiences.

• He disagreed with the need for diagnostic manuals.

Thomas Szasz clearly stands against the medical model because he does not believe that symptoms of mental illnesses exist. However, both the medical model and Szasz's theories suggest a physical component to mental illnesses.

Szasz believed that some mental illnesses may be physical issues/ailments that psychiatrists had not identified yet.

Thomas Szasz Research

In his article, The Myth of Mental Illness: 50 Years Later (2011), Szasz reviewed his previous work.

Szasz aimed to change the view of mental illnesses from a medical problem to a linguistic-rhetoric issue. More specifically, he stated that mental illnesses result from a lack of psychiatric knowledge - the symptoms of mental illnesses may result from a physical ailment that psychiatric researchers have not identified yet.

Therefore, the diagnosis of mental illnesses is error physicians make.

However, Szasz reiterated his points in his 2011 revisions. Also, he disregarded current, existing empirical psychological research. The work drew upon evidence from:

• Literature such as making comparisons between Shakespeare's Macbeth.
• Quotes from Socrates (ancient Greek philosopher).

Exploring Alternatives To The Medical Model

Psychology is a fragmented discipline. By this, we mean that psychologists debate how mental illnesses should be explained and treated. This is represented by the different schools of thought that vary in their approach to understanding mental health.

Let's look at how behaviourist, cognitive, cognitive neuroscience, psychodynamic, and humanistic psychologists explain mental illness.

Alternatives to the Medical Model: The Behaviourist Explanation

The behaviourist approach explains mental illnesses in terms of learned behaviour and our past experiences. Behaviourists believe that 'abnormal' behaviour can be unlearnt. This is the approach they take when considering appropriate treatments for mental illness. The following behavioural theories explain mental illnesses and their treatment:

One explanation is that people can acquire a condition called 'learned helplessness' wherein, due to associations between life events and lack of control, they have been conditioned to believe they have no control over situations, which can lead to depression.

In terms of depression, behaviourists believe that it occurs due to a learned association between specific stimuli and negative emotions. Operant conditioning explains depression as the result of removing positive reinforcement from the environment.

They may become less social, leading to less and less positive reinforcement in their life, furthering their depressive feelings. In addition, others around them may show sympathy and attention when they see the depressed person's symptoms. This then reinforces the depressed person's behaviour due to the attention and compassion they get.

Alternatives to the Medical Model: The Cognitive Explanation

The cognitive school of thought describes mental illness as a result of faulty thought processes and cognitive distortions. When information is not appropriately processed, this leads to irrational thought processes such as cognitive bias.

For example, Beck, an important figure in cognitive psychology, formed the negative triad theory to explain depression. People with a negative triad tend to negatively see the world and their current and future selves.

Therefore, people with depression continuously see events negatively. This feeds into their depression as they continuously feel low (known as the vicious cycle).

The cognitive explanation of mental illness set a foundation for several types of treatment for mental illness, including cognitive-behavioural therapy (CBT) and cognitive processing therapy (CPT).

However, some, especially behaviourists, may criticise the cognitive explanation of mental illness as it explains behaviour in terms of internal processes that cannot be directly observed, so it is difficult to objectively and empirically test.

Fig. 2 - Cognitive explanations of mental illness focus on the brain and thinking.

Alternatives to the Medical Model: The Psychodynamic Explanation

According to psychodynamic theorists, including Sigmund Freud, mental illness can be caused due to early childhood trauma and the disruption of the balance between the three parts of the mind: the id, the ego, and the superego.

The three parts of the mind (psyche) have their own role but are constantly in conflict. If the id is more in 'control', this can cause maladaptive aggressive or sexual behaviour.

Freud believed that depression is linked to feelings of grief, such as when we lose a loved one. Depression occurs when the grief turns to self-hatred due to childhood experiences.

This leads to feelings of anger towards the parents, but the child cannot directly express this anger to their parents, so the anger is repressed, turning into self-hatred. When a person experiences loss, the repressed feelings come back, leading to depression in adulthood

Mental Health and Well-Being Alternatives to the Medical Model

The humanistic school of thought is a mental health and well-being alternative to the medical model. This approach proposes that humans have free will over their behaviour and aim to reach their maximum potential.

The humanistic school of thought rejects research that compares human and animal findings. This approach considers that animals and humans are different. Humanistic psychologists argue that animal research findings should not be generalised to humans.

Alternatives to the Medical Model: Summary

The table summarises the alternatives to the medical model.