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Alternatives To The Medical Model

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Alternatives To The Medical Model

The medical model and Thomas Szasz's theory

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.

A Hungarian psychiatrist Thomas Szasz was also opposed to the medical model. Let us take a closer look at his beliefs. Thomas Szasz believed that mental health is a myth. He criticised the medical model because:

  • He believed that illnesses considered mental are just ordinary human experiences.

  • He disagreed with the need for diagnostic manuals.

Thomas Szasz research: 'The myth of mental illness: 50 years later' (2011)

This article reviewed his previous work, 'The myth of mental illness'. The key points of the research were:

  • Mental illnesses should not be regarded as diseases.

  • Patients should not be seen as victims of pathobiological factors the individual cannot control.

  • Mental illnesses are a metaphor.

  • The treatment of mental illness depends on the climate of the era.

The 'Myth of mental illness article' 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 are errors physicians make. The treatment of mental illness depends on the climate of the era.

Mental illnesses were initially thought of as a result of religion. According to Szasz, the way mental illnesses are viewed is based on political motives.

It is important to note that Szasz's research was initially done in the 1960s. During this time, mental health was referred to as 'psychoses' and 'neuroses'. People with mental health illnesses were not always treated humanely. This can explain the radical theories noted in his research. The published work was based on his subjective thoughts and observations rather than conclusions formed after testing.

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)

This shows that Szasz's published work was based on early work that had been disproved and evolved. In addition, it made inferences from fiction literature. Therefore, the research did not follow the scientific approach psychology research requires.

Based on these findings, Thomas Szasz clearly stands against the medical model because he does not believe that there are symptoms of mental illnesses. However, both the medical model and Szasz's theories suggest that there is a physical component to mental illnesses. Szasz believed that some mental illnesses may be physical issues/ailments that psychiatrists had not identified yet.

The medical model suggests that physical causes, such as trauma or faulty neurobiological processes, cause mental illnesses.

Exploring alternative schools of thought to the medical model

Psychology is a fragmented discipline. By this, we mean that there is debate amongst psychologists on how mental illnesses should be explained and treated. Within psychology, there are different schools of thought that vary in how mental health should be understood, such as whether or not our environment or childhood play an integral part in the onset of mental health. Let us take a look at how behaviourist, cognitive, cognitive neuroscience, psychodynamic, and humanistic psychologists explain mental illness.

Alternatives to the Medical Model, an image of the brain and different approaches in psychology, StudySmarter

Different approaches to the explanation of mental illnesses, Manreet Thind, StudySmarter Originals

The behaviourist explanation of mental illness

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:

Classical conditioning - mental illnesses are learned when people form associations between conditional stimuli and responses.

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.

Someone may form a phobia of enclosed spaces after associating it with the anxiety they experience when in small spaces.

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 the removal of positive reinforcement from the environment.

Operant conditioning - mental illnesses are learned via positive and negative reinforcement.

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.

Social learning theory - abnormal behaviour results from imitating role models.

If someone observes a celebrity they admire engaging in maladaptive behaviour such as extreme dieting, the individual is likely to do the same, which can cause an eating disorder such as anorexia.

Evaluation of the behavioural approach to explaining mental illness

The following section explores the strengths and weaknesses of the behavioural approach to explaining mental illnesses.

Strength

The behavioural approach has applied theories for treating mental illnesses commonly used as treatment methods. Some of these are:

  • Systematic desensitisation - uses the classical conditioning theory to treat mental illnesses. This treatment involves forming new associations that encourage 'typical/healthy' behaviour.
  • Behaviour modification - applies the operant conditioning theory to treat mental illnesses. This is done by rewarding 'healthy' behaviour through positive reinforcement. This encourages patients to continue the behaviour. Maladaptive behaviour is discouraged via negative reinforcement.

Weakness

This approach does not consider the role of nature in the nature versus nurture debate. Genetics, brain abnormalities, and neurochemistry play an important role in mental illnesses. However, this approach does not take this into account. Therefore, the theory can be considered reductionist.

The cognitive explanation of mental illness

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.

Beck, an important figure in cognitive psychology, formed the negative triad theory to explain depression. People with a negative triad tend to see the world and their current and future selves negatively. Therefore, people with depression continuously see events negatively. This feeds into their depression as they continuously feel low (this is known as the vicious cycle).

Evaluation of the cognitive approach to explaining mental illness

Like the previous, this model also has its strengths and weaknesses.

Strength

The cognitive approach takes an interactionist stance in the nature versus nurture debate. This essentially means that the theory considers both sides of the debate. The cognitive approach states that our behaviours (nurture) influence the internal mental processes that we are born with (nature).

Weakness

This school of thought explains behaviour in terms of internal processes. This cannot be directly observed, so it is difficult to objectively and empirically test.

The psychodynamic explanation of mental illness

Freud stated that there are three parts of the mind (the tripartite model). These are the:

  • id - primitive instincts such as sexual and aggressive desires

  • ego - the realistic part that moderates the id and superego

  • superego - our morals

According to psychodynamic theorists, mental illness can be caused due to early childhood trauma and the disruption of the balance between the three parts of the mind. 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, which is brought about due to childhood experiences of one's parents. A child's parents could be very cold towards them yet still demand things from their child, like being the best in the class at school.

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.

Evaluation of the psychodynamic approach to explaining mental illness

Let us explore the strengths and weaknesses of this approach.

Strength

This theory highlights the importance of childhood experiences such as trauma, relationships and how they shape later life.

Weakness

Many psychologists argue that the psychodynamic school of thought is a pseudo-science. This is because it is difficult to disprove theories that they propose empirically.

The cognitive neuroscience explanation of mental illness

Cognitive neuroscientists explain mental illness in terms of dysfunction in brain areas. Psychologists generally agree that certain brain regions are responsible for specific jobs.

Cognitive neuroscientists propose that mental illnesses are caused by damage to brain regions or disruptions. This influences how the brain functions.

Evaluation of the cognitive neuroscience approach to explaining mental illness

Based on everything you've read so far, try to make your assumptions about the strengths and weaknesses of this approach.

Strength

Theories are usually supported with research from brain imaging techniques. This means that the research theories and evidence are empirical and highly valid.

Weakness

There are limitations to using brain imaging techniques. For example, magnetic resonance imaging (MRIs) cannot give information on the timing of brain activity. To deal with this, researchers may have to use multiple imaging methods. This can be costly and time-consuming.

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.

Humanistic psychologists believe that mental illnesses such as depression result from people not being able to reach their full potential.

Evaluation of the humanistic approach to explaining mental illness

Like all previous approaches, this one has its strengths and weaknesses.

Strength

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.

Weakness

The humanistic theory is not widely applied in psychology compared to other approaches.

Alternatives To The Medical Model - Key takeaways

  • The medical model is a school of thought in psychology that explains mental illness as a result of a physical cause.
  • Szazs disagreed with the medical model as he believed that mental health is a myth.
  • The behavioural approach disagrees with the medical model as they argue mental illnesses are due to learned behaviour through classical and operant conditioning.
  • The psychodynamic school of thought argues mental illnesses are 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 cognitive approach argues that faulty thought processes and cognitive distortions cause mental health issues.

Frequently Asked Questions about Alternatives To The Medical Model

Behaviourist, psychodynamic, cognitive, cognitive neuroscience and humanistic schools of thought are alternatives to the medical model. 

Szasz criticised the medical model because:

  • He believed that things considered mental illnesses are just ordinary human experiences. 
  • He disagreed with the need for diagnostic manuals. 

Thomas Szasz's theory was that mental illnesses are a myth. 

A limitation of the medical model is that it only considers biological explanations of mental illnesses. It ignores other factors such as cognitive, psychodynamic, and humanistic. This suggests that the model over-simplifies the complex nature of mental illnesses by ignoring important factors.  

The strengths of the medical model are: 

  • The approach tends to be objective and follows an empirical approach to diagnosing and treating mental illnesses. 
  • There is research evidence such as  Gottesman et al. (2010) that shows a genetic and biological component to mental illnesses. 
  • The medical model has real-life practical applications. For example, it describes how people with mental illnesses should be diagnosed and treated. 

Final Alternatives To The Medical Model Quiz

Question

What did Szazs think of mental illnesses? 

Show answer

Answer

They are a myth

Show question

Question

Which theories take an interactionist approach in the nature versus nurture debate? 

Show answer

Answer

Cognitive

Show question

Question

Which theory criticises the cognitive approach for not measuring phenomena that are directly observable? 

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Answer

Behavioural 

Show question

Question

Which type of reinforcement is used to encourage 'healthy' behaviour in behaviour modification therapy? 

Show answer

Answer

Positive reinforcement 

Show question

Question

Which type of reinforcement is used to discourage 'unhealthy' behaviour in behaviour modification therapy? 

Show answer

Answer

Negative reinforcement 

Show question

Question

What is a strength of the psychodynamic approach to explaining mental illness?

Show answer

Answer

The psychodynamic theory highlights the importance of childhood experiences such as trauma, relationships and how they shape later life. 

Show question

Question

How does the classical conditioning theory explain mental illnesses and apply this to our understanding of phobias? 

Show answer

Answer

The classical conditioning theory describes that mental illnesses are learned when people form associations between a conditional stimulus and response. For example, someone may form a phobia of enclosed spaces after associating it with panic attacks they have when in small spaces.   

Show question

Question

Which theory has some commonalities with the medical model? 

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Answer

Cognitive 

Show question

Question

How do cognitive neuroscience and the medical model differ in terms of explaining mental illnesses? 

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Answer

Cognitive neuroscience and the medical model differ as cognitive neuroscientists do not place as much emphasis on diagnostic criterias as the medical model does.

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Question

Which theories emphasise the role of experiences shaping mental illnesses? 

Show answer

Answer

Behavioural 

Show question

Question

Is the following statement true or false, "the medical model and the humanistic approach take opposing stances in the free will versus determinism debate"?

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Answer

True

Show question

Question

How did Beck's theory explain depression? 

Show answer

Answer

Beck formed the negative triad theory to explain depression. People with a negative triad tend to see the world, their current and future selves negatively. Therefore, people with depression continuously see events negatively. This feeds into their depression as they continuously feel low (this is known as the vicious cycle). 

Show question

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