Booklet 3: Alternatives to the Medical model
Booklet 3: Alternatives to the Medical model
The Behaviourist explanation of Mental Illness
All behaviour learned. 2. What's learned can be unlearned. 3. Abnormal behaviour learned same way as normal
Learn through association, response like a reflex, emotional response linked with a neutral stimulus. Little Albert, explaining development of phobias in humans.
Behaviour is learnt through consequences of actions, learn through reinforcement, both positive and negative. Positive-reward. Negative-punishment won't happen again. Reason why gambling is so addictive is because it's rewarding. Explains phobias as rewarded when we show fear, e.g. depression caused by dramatic event receive attention rewarded for showing signs of a disorder. Anxiety disorders- negative reinforcement, people with phobia of lifts gets to lift door, gets anxious walks away.
Social Learning Theory:
Depression seen by child witnessed symptoms withdrawal, mood swings and model what they see.
relaxation techniques gradually confronts their fear. Patient relearns feeling of calmness associated with phobia.
Fear inducing stimulus presented directly to patient. Cause adrenaline won't stay for long and will eventually feel calm.
unpleasant association with addiction. Drug used induce sickness when in alcohol situations. So aversion from alcohol.
Token economies (reward/reinforcement)-
Training parents to reinforce non-depressed behaviours, reduce depression. Useful with anorexics.
role models and operant conditioning effective with schizophrenic patients.
Nurture explanation- environmental, situational factors and influence of others.
Ethics- trauma-psychological harm. May give consent but may be institutionalised.
Reductionist- only environmental influences.
Deterministic-patient can't control behaviours learnt.
Usefulness- Practical app- effective treatments developed using behaviourist techniques.
The Cognitive Explanation Of Mental Illness
Proposes dysfunctional behaviour caused by irrational thought.
Psychological problems caused when people make incorrect references about themselves.
Cognitive distortion- inaccurate perception of reality.
Cognitive explanations concerned faults in an individual's process of thinking, attention, reasoning and perception.
Beck's Examples of Cognitive Distortion:
take negative details and magnify them, filter out positive aspects of situation.
Either black or white. Perfect or failure.
One unfortunate event as part of never-ending pattern of defeat.
Expecting situation to be far worse than what it will be.
Everything others do direct personal to you. Compare.
linked to a triad of negative schemas, early experiences form dysfunctional beliefs. Triggered by adverse life incidents, activate-underlying assumptions. Negative bias, symptoms of depression.
is different, less clear cut, Beck accepted biological disposition caused by genes. Clear link between cognitive deficits and schiz patients e.g. memory, attention.
cognitive explanation model, change faulty cognitions to develop alternative thoughts through CBT. Thought-behaviour and emotion.
Key Research: Szasz (2011)
Stated there's no such thing as mental health illnesses.
Article critiques changes in beliefs and concepts surrounding mental health in USA since 1960.
Outline of article:
Mental illnesses aren't like biological diseases, not based on scientific research used to control people without consent. More like prisons not medical care. Subjective judgement for diagnosis. Medical model's inhumane, patients should have the right to control and define own lives. Recent years more careful with diagnoses, closure of mental hospitals. Patients have more rights.
7 sections of the journal:
1. Fifty years of change in US mental healthcare-
Mental hospitals were more like prisons. Big businesses in pharmaceuticals and treatments.
2. Mental illness- medical/legal concept?-
individuals with mental illness forced into diagnosis and treatment- unethical.
3. Mental illness is a metaphor-
myth, not scientifically proven. Not medical problem.
4. Changing perspectives on human life (and illness)-
People deprived of freedom. Understand reasons by respecting, understanding and helping.
5. Mental illness is in eye of the beholder-
no identifiable cause of mental illness. Subjective, not based on scientific assessment. Judging 'bad' behaviour of people.
6. Revisiting The Myth of mental illness-
dehumanising, medical treatments don't work just suppress symptoms
7. Having an illness doesn't make an individual into a patient-
criticised biological methods to treat mental health disorders.
Psychiatry is a pseudoscience.
Mental illness is a myth.
Mental illness now considered legal concept and controlled by government.
Old religious-humanistic perspective been replaced with a medical model.
Wrong to treat individuals called 'mentally ill' as sick patients needing psychiatric treatment- right to define and control own lives.
The Humanistic Explanation of Mental Illness.
Understand human nature simple principles and minimum theory.
Rejects psychiatric diagnosis.
People are good and can grow as individuals.
Occur when external forces prevent growth.
Classification and diagnosis-unhelpful.
Humanistic centres view on each person as unique and individual, freewill to change in life. Responsible for own happiness and well-being.
Whole person (holistic) innately good. Deviations from natural tendency cause mental disorders.
Maslows Hierarchy of Needs:
basic needs for physical survival, motivating behaviour. Once fulfilled reaches next level, etc.
influential, proposed understanding healthy psychological development on several factors.
The actualising tendency:
humans have one basic motive, self-actualisation, highest level of 'human-beingness' we can. People are inherently good. Become destructive when poor self-concept interfere. Must be in a state of congruence for self-actualisation.
Image of ourselves. Individual perceptions of behaviour, abilities, unique characteristics. More flexible when people are young.
We should all receive unconditional love-promotes congruence.
3 different parts of Self concept: 1. Self-image- how you see yourself, may not link with reality. 2. Self-esteem- how much you value yourself. How we compare ourselves to others and how others respond to us. Respond positive= positive self esteem. 3. Ideal self- how you wish you could be. Don't match with how we see ourselves.
Congruence when self-concept fairly well aligned with reality. Incongruence is when it's not. If parents place conditions on affection for children, cause distorted memories, feel unworthy, more vulnerable and vulnerable to depression.
Application: Non-biological treatments of depression
Cognitive Behavioural Therapy (CBT) to treat depression:
Helps with anxiety such as PTSD, depression, OCD. Identify rational thoughts. Thought-behaviour-emotion.
Aims are: 1. To re-establish previous levels of activity. 2. Re-establish social life. 3. Challenge patterns of negative thinking. Learn to spot early signs of recurring depressions. Change unhelpful thoughts and behaviours. Practice changes in daily life. Help manage depression. once a week/fortnight for 5-20 sessions, 30-60 mins.
Humanistic therapy to treat depression: Person-centred counselling.
Deals with the way individuals perceive themselves rather than how counsellor interprets unconscious thoughts or ideas. 'clients' rather than 'patients'. Used to treat depression.
Unconditional positive regard.