The medical model of mental illness is an important perspective in psychology. However, with its advantages come several disadvantages as well. Can physical causes explain every abnormal behaviour, or are there other approaches to consider? The human mind and experience are far too complex. So what are the alternatives to the medical model?
- First, we will understand what the medical model is in psychology.
- What are the implications of the medical model?
- Then, let's discuss the medical model and Thomas Szasz's Theory.
- We'll continue by exploring alternatives to the medical model.
- What are the mental health and well-being 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.
The medical model suggests that physical causes, such as trauma or faulty neurobiological processes, cause mental illnesses and takes a biological approach to explain mental health.
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.
An advantage of this is that it can lead to an increased focus on finding treatments to 'fix the problem.'
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:
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' and people with mental health illnesses were not always treated humanely.
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.
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.
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.
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 mental illnesses approaches are politically motivated.
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.
For example, whether or not our environment or childhood plays an integral part in the onset of mental health is argued as important in the psychodynamic approach but not in the biological.
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:
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 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.
While this approach offers several strengths, it 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.
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.
The negative triad theory - states that our negative self-schema maintains our: 1) negative views of the world, 2) negative views of ourselves, and 3) negative views of our future.
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.
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
This theory highlights the importance of childhood experiences such as trauma and relationships and how they shape later life. However, 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.
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, i.e. not achieving self-actualisation and not receiving their needs.
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.
| School of Thought | Theorised Cause of Mental Health |
| Biological | Irregular neurotransmitters, physical trauma or lesions/ dysfunction in brain regions |
| Cognitive | Faulty cognitive processes and cognitive distortions |
| Psychodynamic | Childhood experiences |
| Behavioural | Results from forming associations between stimuli response or from the removal of positive reinforcement |
| Humanistic | Results from dissatisfaction from not reaching self-actualisation or not receiving their basic needs |
Alternatives To The Medical Model - Key takeaways
- The medical model psychology is a school of thought that explains mental illness due to a physical cause.
- The medical model and Thomas Szasz's theory do not align as Szasz disagreed with the medical model as he believed mental health is a myth.
- When exploring the alternatives to the medical model, the alternative school of thought you may come across are the biological, cognitive, psychodynamic and behavioural approaches.
- 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.
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