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 Blooming Stars

Diathesis-Stress Model

            Diathesis-Stress Model:This model takes into account both genetics and environment, nature and nurture. Diathesis refers to a genetic predisposition toward an abnormal or diseased condition. While genetic factors predispose one for a mental disorder, whether that disorder is going to be expressed in reality would depend on a particular environmental stress as a precipitating factor. So both are necessary for a disorder to take place: hereditary predisposition and environmental stress. This model actually is a catch-all category in that it includes one way or another all other models. It is too general to be of great use. Yet two persons having the same or similar attributes and the environment, one of them manifests a mental disorder, and the other does not. How can we explain this situation except by some kind of predisposition that is not associated with the life stressors? It is also important to note that identical twins reared apart only have a high percent but not 100 percent concordance rate for mental disorders. This strongly suggests some environmental factors or life experiences other than genetic vulnerability at work. Isolating environmental stressors, persons can be protected from them so the hereditary vulnerability may be prevented from being expressed.

            In conclusion, the important models of psychopathology presented above give a handle on the very complicated process of the origin and development of mental disorders. The psychiatrists predominantly follow a bio-chemical model. They study the neuro-chemistry of the brain, the neuro-transmitters, and the cell structure with a view to correcting any chemical imbalance that could result in mental disorders. The chemical imbalance theory certainly diminishes the social stigma attached to mental disorders. It is still a theory that is researched in order to develop the right kind of drugs that can target the problems. While new drugs come into the market, the research is still far away from achieving the right kind of drugs that can treat various diagnoses.

             The psychological models are also based on theories that have the accuracy only of social sciences. While the cognitive-behavioral model seems to yield empirically better results in that this model is better suited for research. The psychological models comprise various theories and schools of psychologies and psychotherapies. Psychotherapies are methods of learning, re-learning, or unlearning used with emotionally or mentally disordered persons to change their thinking (cognition), feelings (affect), and acts (behavior). Therapist-client relationship or therapeutic alliance is a very important factor in bringing about change in the clients. What works for one client may not work for another. One may not know for sure.what really works at any given point so there is art and science as well as a body of solid psychological knowledge at work. Some important psychotherapies in the western setting include psychoanalysis, psychodynamic psychotherapy, rational-emotive therapy, person-centered therapy, behavior therapy, cognitive therapy, existential psychotherapy, gestalt therapy, and transactional analysis aimed at insight for change. Asian therapeutic methods such as meditation, yoga, Reiki, and Pranic healing are becoming more popular; they aim at awareness and consciousness.

            Insight and awareness or consciousness convert knowledge into wisdom and eventual change necessary for effective and purposeful coping with stress in life. More systematic work and research need to be done in India in the area of therapeutic modalities. Clinical psychologists in India have not. To my knowledge, asserted their rightful place in the field of mental health. They do not seem to have progressed much from the days if Delhi University days in the 1960’s. Practical training in psychology and psychotherapy is abysmally weak, and knowledge base is very poor. Psychological problems not recognized and adequately dealt with. Many psychiatrists in the USA and India appear to overmedicate their patients. Psychiatrists in India who came into my knowledge appear to be autocrats who do not like to be questioned in connection with legitimate and needed knowledge, and are plenty happy in generously dispensing drugs without even proper diagnosis. While generalization from a few instances is very dangerous, I have no hesitation in saying that at least some psychiatrists in India need to examine their manners in dealing with their patients. They need to realize that they are employees like others who are paid for their services.


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