Alternatives to the Medical Model (The Behaviourist explanation (Proposes…
Alternatives to the Medical Model
The Behaviourist explanation
Proposes that mental illness is learned, much like any other behaviour. It assumes it's determined by external events, and is driven by past experiences or anticipation of future outcomes
Classical conditioning: learned through association. Pavlov- a dog salivates when it smells food in response to a neutral stimulus e,g learns to associate a bell with receiving food and thus salivates.
CC-Learned helplessness. Early experiences of lack of control mean that later in life, when faced with a similar situation, we respond with passivity, inaction and depression
Operant conditioning: learning through reinforcement and punishment- stimulus that produce a desirable outcome are reinforced and used again
When positive reinforces from the environment are removed, people are less likely to seek out other social situations (avoidance), further reducing their positive reinforcers. This may lead to friends and family losing contact and resulting in depression
Research: David Ekers used a meta-analysis of 17 studies and found operant conditioning can be highly effective in treating depression- rescheduled daily activities to reintroduce positive reinforcement was found to be significantly more effective than the control groups.
The Cognitive explanation
This areas suggests mental illness is due to mental internal processes being the cause of behaviour- more specifically of faulty mental processes
Beck argues that patients with depression create a series of cognitive errors- refers to this as a cognitive triad. It is a pessimistic and irrational view 1) the self- belief that they are worthless 2) the future- thinking it will be negative 3) the world- thinking everyone and everything is negative
These beliefs create negative schemas- preconceptions where the patient expects the situation to be negative and therefore interprets it negatively- lead to a systematic cognitive bias in thinking e.g draw conclusions regarding self-worth based on one piece of feedback. Beck suggests they stem from criticism, rejection and over-expectations in early childhood.
Hammen and Krantz used 33 female depressed students and found they were more likely to show distortions in their cognitions when receiving feedback on a performance task than neurotypical people
Andrew Butler found reduced depressive symptoms using cognitive therapy- suggests the orginional cause of depression must have been faulty cognitions
The Humanistic explanation
Emphasises the importance of free will and rejects determinism (outside influences) characterised by other explanations. It suggest the person is in control and has the capacity for self-direction
Self-actualism: the ability to realise potential, accept ourselves and develop relationships with others. This approach suggests depression occurs when external factors inhibit the potential growth of these factors. When a person is being controlled by other things, they can't take responsibility for their actions, thus cannot change them.
The ideal self- depressed patients can be trapped a downward spiral when they feel they aren't living up to their ideal-self. This makes them feel under threat, and use defence mechanisms, such as distortion, to deal with this e.g distorting their perception of the threat until it fits their self-concept. This dimishes a persons contact with reality, making it more difficult to fulfil their ideal self. When these defence mechanisms become less effective, depressive symptoms show- realise they cannot bridge the gap between who they are and who they would like to be
Research: Liu Hui found 15 patients who were given humanistic nursing displayed reduces symptoms of depression after 6 weeks of treatment.
Szasz on the myth of mental illness