Alternatives to the Medical Model

Question 1

What is the Behaviourist Model for Mental Illness ?

Answer 1

• Abnormal behaviour is the consequence of abnormal learning from the environment
• Learnt to be abnormal
• Learned through CO, OC, SLT
• What is learnt can be unlearnt

Question 2

How does Classical Conditioning cause Mental Illness ?

Answer 2

• Learn by association
• Pair two stimuluses together which we learn to associate
• So reactions like phobias could be learned. We are startled when someone screams at seeing a spider. We learn to associate the spider with that fear.

Question 3

How does Operant Conditioning Cause Mental Illness ?

Answer 3

-Learn through reinforcement and punishment

Question 4

How does SLT cause Mental Illness ?

Answer 4

-Learn by observation
-People observe the behaviour of other people (models)
-May imitate the behaviour they observe
-Whether or not they do so depends on the observed consequences:
Vicarious reinforcement
Vicarious punishment

Question 5

What is Systematic desensitisation ?

Answer 5

• Behavioural treatment
• Based on Classical Conditioning
• Patients learn to relax
• Taken through a hierarchy of increasingly frightening stimuli whilst relaxing
• Learn to associate the stimulus with relaxing

Question 6

What is Aversion therapy ?

Answer 6

• Behavioural treatment
• Based on Classical Conditioning
• Patients learn to link negative associations to objects (stimulus)

Question 7

What are strengths of the behavioural explanation for Mental Illness ?

Answer 7

• Provides a simple, testable explanation that is supported by experimental evidence.
• Predicts that people can change their behaviour through relearning.

Question 8

What are weaknesses of the behavioural explanation for Mental Illness ?

Answer 8

• Criticised as being dehumanising and mechanistic. People are reduced to programmed stimulus-response units.
• Cannot explain all psychological disorders. Conditioning cannot cure conditions like schizophrenia.

Question 9

What is the Cognitive Model for Mental Illness ?

Answer 9

• Abnormal behaviour is caused by abnormal thinking processes, negative schemas, inaccurate perception, poor reasoning and problem solving
• If our ways of reasoning are inadequate then our emotions and behaviour may become disordered

Question 10

What are Cognitive Treatments for Mental Health ?

Answer 10

• Aim to change the faulty cognitions and are often combined with behavioural techniques in cognitive behavioural therapy.
• Involves the therapist helping the client to see how their irrational beliefs are contributing to their illness. They then act on that understanding.
• Focuses on the here and now.
• Helps people look rationally at their fear and anxiety

Question 11

What are Strengths of cognitive explanations for Mental Health ?

Answer 11

• Focuses on how the individual experiences the world and his or her feelings and beliefs, rather than relying on interpretations by other people.
• Hopeful, assumes people have the power to change their behaviour.

Question 12

What are the Weaknesses of the cognitive explanation?

Answer 12

• Encourages the idea that people are responsible for their own psychological problems, could lead to people being blamed for psychological abnormalities.
• Reductionist, ignores biological causes of psychological abnormality, such as genetics or biochemistry.

Question 13

What ethical issues are there for the Cognitive Model ?

Answer 13

• Blames the victim for their faulty thinking processes
• A person might be depressed because their situation is genuinely dreadful – but the cognitive model implies that the problem is their perceptions

Question 14

Why is it difficult to establish cause and effect in the Cognitive Model ?

Answer 14

• Does the faulty thinking cause the psychological problem ?

- Does the psychological problem cause the faulty thinking ?

Question 15

What is the Psychodynamic Model for Mental Health ?

Answer 15

• Psychological disorders caused by emotional problems in unconscious mind
• Causes of these emotional problems traced back to early childhood
• Relationship between child and parents is a crucial determinant of mental health (particularly mother)
• Defence mechanisms against repressed emotions

Question 16

What are the 2 sets of motives we have ?

Answer 16

Latent motives – the unconscious forces that drive our behaviour
Manifest motives – the lies we tell ourselves to protect us from the truth

Question 17

What are defence mechanisms ?

Answer 17

• Ego defence mechanisms turn latent motives into manifest ones
• Unacceptable (latent) motives are channeled into more acceptable (manifest) thoughts and actions
• Aggression=sports

Question 18

What is Reaction formation ?

Answer 18

-Behaving in ways directly opposite to unconscious impulses, feelings.

Question 19

What is the psychodynamic cause of depression ?

Answer 19

-Aggression against the parents turned back in on the self

Question 20

What is the psychodynamic cause of anxiety ?

Answer 20

-Fear of something (e.g. sex) that is projected onto something innocuous

Question 21

How does the psychodynamic define a phobia ?

Answer 21

• Unconscious fears are too unpleasant for the conscious mind to deal with
• These are displaced onto a different target which presents a less threatening problem
• The phobic stimulus is not the real cause of anxiety

Question 22

What are psychodynamic treatments ?

Answer 22

• Freud believed you had to access the unconscious mind through techniques including free association and dream analysis.
• Believed that dreams were the ‘royal road to the unconscious’ to help discover the real conflicts and desires a person was experiencing.
• The manifest content is what the dream seems to be about – the latent content is the true meaning.

Question 23

What are strengths of psychodynamic explanations ?

Answer 23

-Regression may be a factor in psychological
abnormality, evidence of defence mechanisms
-Apter et al (1997) assessed adolescent patients who were suicidal for ego defence mechanisms and found that the suicidal adolescents scored higher on regression and other ego defences.
-Therapies appear to work

Question 24

What are weaknesses of psychodynamic explanations ?

Answer 24

• Negative effect, focuses on cause, can cause patients to become more obsessive about their unconscious thoughts
• Subjective, qualitative self-report data, difficult to replicate, biased interpretation.
• Evidence is usually based on case studies and or subjective qualitative data which may be biased.
• They are not scientific.
• Difficult to test

Question 25

What is Szasz’s argument ?

Answer 25

• Mental illness is a myth, not a disease- can’t be scientifically proven
• Medical model is now the only way of dealing with people who behave differently.
• We need to try to understand the reasons for a person’s actions by respecting, understanding and helping them, not diagnosing under a loose fitting definition.
• People are deprived of the freedom to behave in the way they choose on the grounds of having a disease.

Question 26

How useful are Szasz’s criticisms of the Medical Model ?

Answer 26

• His work had a huge impact on psychiatry and psychology
• Psychiatrists are much more careful in their diagnoses
• Large mental hospitals are closing
• Whole person and the context in which they present is taken into account
• Patients do have more rights.
• Make us question the effectiveness, appropriateness and morality of invasive treatments such as drug therapy, ECT and involuntary confinement of those with mental health issues.

Question 27

What are the reasons Szasz gives for the unacceptability of the medical model ?

Answer 27

• There is no identifiable cause of mental illness.It is a mistake to keep looking for biological causes.
• It denies people freedom and responsibility to choose how to behave. They are forced into diagnosis and treatment, which is unethical.
• Diagnosis is subjective, not based on scientific assessment. Judges the ‘bad’ behaviour of people.
• Medical model is dehumanising, ignores suffering of person. Labels are constructed due to medicalisation of disturbed behaviour.
• Alternative ways – understanding the patient, help them help themselves. Medical treatments do not work, only supress symptoms.

Question 28

What is unethical about Szasz’s research ?

Answer 28

• His work can be considered socially sensitive and highly controversial.
• People experiencing mental health difficulties could be distressed to hear their illness described as a ‘myth’ when they perceive their symptoms and diagnosis as real and may have experience of effective treatment.
• Overstates the case against the medical model and risks bringing the professions of psychiatry and psychology into disrepute.