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 Blooming Stars

Medical Model

            Psychopathology or the study of mental dysfunctions or disorders is looked at from the points of view of various schools of psychology. Each school has its own understanding of psychological wellness, disease process, treatment, and as well as its own model of psychopathology. Evidence-based studies with regard to the effectiveness of diagnosis and treatment of mental disorders are coming in. At some point in the future, it is hoped, that an effective model of psychopathology that will help accurately diagnose and treat various mental disorders will be formulated. Currently some of the important models of psychopathology are described.

            Medical Model:This model presupposes that there is a chemical cause in the brain for the origin of mental disorders. By blocking or increasing appropriate neurotransmitters by means of drugs, chemical balance is restored and the respective mental disorders are brought into remission. The word cure is rarely used in treating mental disorders; the operative word is remission. Persons who are having mental disorders often talk about having chemical imbalance – a socially acceptable term – in the brain, and are prescribed psychiatric drugs. Many thousands of mental patients that were kept in huge, secure mental hospitals were released into the community with outpatient clinic services with the advent of powerful psychotropic drugs. Chemical restraints in terms of drugs substituted crude, cruel, and inhuman physical restraints.

            More humane treatment of mental disorders was instituted. Currently violent, psychotic, and unmanageable patients are sedated. There are tranquilizers that calm and relax patients, and hypnotics that induce sleep. There are problems with medical model as well as medications. Identical twins reared apart may not all develop disorders. There are severe side effects of medications for which further medications will be necessary. Some medications are addictive. Once a patient is on medication, he or she may be on it interminably. Poly-pharmacy (combination of medications to treat a disorder) is not uncommon. The effectiveness of medication in mental disorder is not proven as in physical disease. Psychiatrists can be vulnerable to drug companies that provide very attractive inducements and tempting offers to prescribe their products. It is also important to note that drug companies spend more money on advertisements and commercials than on actual research and development of drugs.

            The Psychoanalytic Model:Psychoanalysis formulated by Sigmund Freud model had its day. Yet it is important to note as it made revolution in psychology. The psycho-sexual stages developed by Freud exerted great influence in the field of psychology. The personality is formed at a very early age. The core of personality consists of id (the pleasure-seeking aspect) ego (the reality, executive function), and super-ego (the conscience, the moral-ethical guide). An optimal balance between these three elements constitutes a balanced and healthy personality. Heredity and psychic determinism play an important role. The arrest of development at any particular psycho-sexual stage leads to certain typical mental disorders. Psychoanalysis is the treatment of choice.

            Psychodynamic Model the ego psychologists extended the psycho-sexual stages into adult life to cover the entire span of one’s life. Erik Erickson’s psychosocial development consisting of eight stages of growth indicating Trust versus Mistrust, Autonomy versus Shame, Initiative versus Guilt, Industry versus Inferiority, Identity versus Role Confusion, Intimacy versus Isolation, Generativity versus Stagnation, and Ego Integrity versus Despair are a very valuable contribution. In these stages virtues/challenges such as hope, will, purpose, competence, fidelity, love, care, and wisdom are to be acquired/mastered. Each succeeding stage is built on the preceding stage. And a healthy personality passes through successful completion of all stages to arrive at the goal of wisdom. Challenges not successfully completed lead to problems/disorders in life. Psychodynamic psychotherapy is the treatment of choice.

 

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